Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study
Introduction: Urolithiasis is one of the most common pathological diseases, which is increasing day by day all over the world. It is important to understand the pathology, risk factors and various treatment modalities to tackle this prevalent disease. The management varies based on factors such as s...
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JCDR Research and Publications Private Limited
2025-03-01
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| author | Vilas Sabale Ashish Gavade Vikram Satav |
| author_facet | Vilas Sabale Ashish Gavade Vikram Satav |
| author_sort | Vilas Sabale |
| collection | DOAJ |
| description | Introduction: Urolithiasis is one of the most common pathological diseases, which is increasing day by day all over the world. It is important to understand the pathology, risk factors and various treatment modalities to tackle this prevalent disease. The management varies based on factors such as stone size, location and patient preference.
Aim: To compare Extracorporeal Shock Wave Lithotripsy (ESWL) and Retrograde Intrarenal Surgery (RIRS) for a single renal calculus of size between 10 and 20 mm.
Materials and Methods: A prospective interventional study was performed in the Department of Urology at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India, from October 2022 to October 2024. The population included individuals aged 18 to 60 years with a single renal calculus of 10 to 20 mm, who were eligible for either RIRS or ESWL. A total of 40 patients were studied and divided into two groups of 20. Various variables, such as duration of the procedure, complications, stone clearance, hospital stay, hospital visits and need for ancillary procedures, were compared. The Chi-square test was used to analyse categorical variables and statistical significance was considered when the p-value was <0.05.
Results: The mean age of patients was 38.6±11.29 years for RIRS, while for ESWL, it was 40.3±9.49 years. Thirteen patients (32.5%) were from the 31-40 years age group. Present study had 25 patients (62.5%) with calculus sizes between 10-15 mm, while the rest were between 16-20 mm. Fourteen (35%) had middle calyx stones, 11 (27.5%) had lower calyceal stones, nine patients (22.5%) had renal pelvis calculi, and 6 (15%) had upper calyx stones. All RIRS procedures were completed within 120 minutes, while 9 (22.5%) undergoing ESWL took 150 to 180 minutes. Seventeen patients (85%) in the RIRS group achieved complete stone clearance, while stone clearance in the ESWL group was seen in 12 patients (60%). Both groups had similar complication rates of 25%. Haematuria was observed in three patients (15%) in the RIRS group and in four patients (20%) in the ESWL group. Pain was reported in two patients (10%) in the RIRS group and five patients (25%) in the ESWL group. Although sepsis occurred in one case (5%) of the RIRS group, none was reported in the ESWL group. Ten patients (50%) in the ESWL group did not required a hospital stay, compared to 16 patients (80%) in the RIRS group who required a stay of 3-4 days. All patients of RIRS needed only one visit for treatment, while four patients (40%) in the ESWL group required four visits, three patients (15%) required three visits, five patients (25%) required two visits and only four patients (20%) completed their treatment in one visit. Seventeen patients (85%) in the RIRS group did not required any ancillary procedures, while 12 patients (60%) in the ESWL group did not required any ancillary procedures.
Conclusion: Both procedures have their own benefits. RIRS showed better stone clearance but is invasive in nature, whereas ESWL, being non invasive, required multiple hospital visits and could be performed on an outpatient basis. Therefore, the choice of procedure should be individualised for each patient, depending on both surgeon and patient preferences. |
| format | Article |
| id | doaj-art-aad1224c3ce644219c1026c08ca5a9f3 |
| institution | OA Journals |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-aad1224c3ce644219c1026c08ca5a9f32025-08-20T02:15:47ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193182110.7860/JCDR/2025/77166.20715Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional StudyVilas Sabale0Ashish Gavade1Vikram Satav2Professor, Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.Resident, Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.Professor, Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.Introduction: Urolithiasis is one of the most common pathological diseases, which is increasing day by day all over the world. It is important to understand the pathology, risk factors and various treatment modalities to tackle this prevalent disease. The management varies based on factors such as stone size, location and patient preference. Aim: To compare Extracorporeal Shock Wave Lithotripsy (ESWL) and Retrograde Intrarenal Surgery (RIRS) for a single renal calculus of size between 10 and 20 mm. Materials and Methods: A prospective interventional study was performed in the Department of Urology at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India, from October 2022 to October 2024. The population included individuals aged 18 to 60 years with a single renal calculus of 10 to 20 mm, who were eligible for either RIRS or ESWL. A total of 40 patients were studied and divided into two groups of 20. Various variables, such as duration of the procedure, complications, stone clearance, hospital stay, hospital visits and need for ancillary procedures, were compared. The Chi-square test was used to analyse categorical variables and statistical significance was considered when the p-value was <0.05. Results: The mean age of patients was 38.6±11.29 years for RIRS, while for ESWL, it was 40.3±9.49 years. Thirteen patients (32.5%) were from the 31-40 years age group. Present study had 25 patients (62.5%) with calculus sizes between 10-15 mm, while the rest were between 16-20 mm. Fourteen (35%) had middle calyx stones, 11 (27.5%) had lower calyceal stones, nine patients (22.5%) had renal pelvis calculi, and 6 (15%) had upper calyx stones. All RIRS procedures were completed within 120 minutes, while 9 (22.5%) undergoing ESWL took 150 to 180 minutes. Seventeen patients (85%) in the RIRS group achieved complete stone clearance, while stone clearance in the ESWL group was seen in 12 patients (60%). Both groups had similar complication rates of 25%. Haematuria was observed in three patients (15%) in the RIRS group and in four patients (20%) in the ESWL group. Pain was reported in two patients (10%) in the RIRS group and five patients (25%) in the ESWL group. Although sepsis occurred in one case (5%) of the RIRS group, none was reported in the ESWL group. Ten patients (50%) in the ESWL group did not required a hospital stay, compared to 16 patients (80%) in the RIRS group who required a stay of 3-4 days. All patients of RIRS needed only one visit for treatment, while four patients (40%) in the ESWL group required four visits, three patients (15%) required three visits, five patients (25%) required two visits and only four patients (20%) completed their treatment in one visit. Seventeen patients (85%) in the RIRS group did not required any ancillary procedures, while 12 patients (60%) in the ESWL group did not required any ancillary procedures. Conclusion: Both procedures have their own benefits. RIRS showed better stone clearance but is invasive in nature, whereas ESWL, being non invasive, required multiple hospital visits and could be performed on an outpatient basis. Therefore, the choice of procedure should be individualised for each patient, depending on both surgeon and patient preferences.https://jcdr.net/articles/PDF/20715/77166_CE[Ra1]_F(SHU)_QC(PS_IS)_PF1(AG_SL)_PFA(IS)_PB(AG_IS)_PN(IS).pdfminimal invasive surgerynon invasive procedurestone clearancestone disease |
| spellingShingle | Vilas Sabale Ashish Gavade Vikram Satav Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study Journal of Clinical and Diagnostic Research minimal invasive surgery non invasive procedure stone clearance stone disease |
| title | Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study |
| title_full | Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study |
| title_fullStr | Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study |
| title_full_unstemmed | Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study |
| title_short | Comparison between Extracorporeal Shock Wave Lithotripsy and Retrograde Intrarenal Surgery for Single Renal Calculus: A Prospective Interventional Study |
| title_sort | comparison between extracorporeal shock wave lithotripsy and retrograde intrarenal surgery for single renal calculus a prospective interventional study |
| topic | minimal invasive surgery non invasive procedure stone clearance stone disease |
| url | https://jcdr.net/articles/PDF/20715/77166_CE[Ra1]_F(SHU)_QC(PS_IS)_PF1(AG_SL)_PFA(IS)_PB(AG_IS)_PN(IS).pdf |
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