Percutaneous nephrolithotomy vs. extracorporeal shockwave lithotripsy for treating a 20–30 mm single renal pelvic stone

Peer review under responsibility of Arab Association of Urology.

Abstract

Objective:

To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20–30 mm single renal pelvic stone.

Patients and methods:

The computerised records of patients who underwent PNL or ESWL for a 20–30 mm single renal pelvic stone between January 2006 and December 2012 were reviewed retrospectively. Patients aged <18 years who had a branched stone, advanced hydronephrosis, a solitary kidney, anatomical renal abnormality, or had a surgical intervention within the past 6 months were excluded. The study included 337 patients with a mean (SD, range) age of 49.3 (12.2, 20–81) years. The patients’ criteria (age, sex, body mass index) and the stone characteristics (side, stone length, surface area, attenuation value and skin-to-stone distance) were compared between the groups. The re-treatment rate, the need for secondary procedures, success rate, complications and the total costs were calculated and compared.

Results:

In all, 167 patients were treated by ESWL and 170 by PNL. The re-treatment rate (75% vs. 5%), the need for secondary procedures (25% vs. 4.7%) and total number of procedures (three vs. one) were significantly higher in the ESWL group (P < 0.001). The success rate was significantly higher in the PNL group (95% vs. 75%, P < 0.001), as was the complication rate (13% vs. 6.6%, P = 0.050). The total costs of primary and secondary procedures were significantly higher for PNL (US$ 1120 vs. 490; P < 0.001).

Conclusions:

PNL was more effective than ESWL for treating a single renal pelvic stone of 20–30 mm. However, ESWL was associated with fewer complications and a lower cost.

Abbreviations:

• PNL, Percutaneous nephrolithotomy
• BMI, Body mass index
• RIRS, Retrograde intrarenal surgery
• SFR, Stone-free rate

Keywords:

• Percutaneous nephrolithotomy
• Extracorporeal shockwaves lithotripsy
• Single renal stone
• Cost

View correction statement:

Corrigendum to “Percutaneous nephrolithotomy vs. extracorporeal shockwave lithotripsy for treating a 20–30 mm single renal pelvic stone” [Arab J. Urol. 13(3) (2015) 212–216]

Notes

Peer review under responsibility of Arab Association of Urology.