Comparative Study of Different Modalities of Management of Patients with Upper Ureteric Calculus in Today’s Era: Study of 50 Cases
DOI:
https://doi.org/10.37506/ijfmt.v17i1.18903Keywords:
: upper ureteric calculi, Extracorporeal Shockwave Lithotripsy (ESWL), Ureterorenoscopy (URS),Pushback Percutaneous Nephrolithotomy (pushback PCNL),Laparoscopic UreterolithotomyAbstract
Background: The incidence of the stone disease has risen significantly over the last several decades because of
modern lifestyles and dietary modifications. This puts a financial liability over the health care delivery system. The
reported lifetime risk of having urinary stone is around 5-21%. Ureteric stones account for 2/3 of all urinary calculi
brought to attention¹. Moreover, the recurrence rates are even more troublesome, reaching 10% at one year, 35% at
five years and 50% at ten years. Since the affliction mainly involves adults with a peak incidence in 3-5th decade,
the loss of work years and deleterious effects on productivity are considerable.
Aims and Objectives:
• To compare the different modalities of treatment in managing the patients presenting with upper ureteric calculus.
• To evaluate the impact of the following in patients with upper ureteric calculus:
a) Age distribution
b) Sex distribution
c) Clinical presentation
d) Sensitivities of radiological investigations
e) Stone size
Study Design: Prospective Study
Sample Size: 50
Duration : June 2020 to June 2022
Conclusion:The most common presenting symptoms of patients are Pain in abdomen, Nausea/ Vomiting and Burning micturition. Amongst all investigations CT-IVP has the highest sensitivity of 100% in diagnosing upper ureteric calculi and assessment of renal function. Analysis shows that URS yields significantly greater stone free rates for majority of the stone stratifications. However, for the stone size <10mm and stone of HU <1000, ESWL is a better option in terms of stone free rates and complication rates. Pushback-PCNL is done only in few selected cases and only when ESWL fails (requiring >3 sittings), • Complications have been reported in all procedures with Bacteriuria/UTI being the most common complication in all, but when considering URS only, the most common overall complication in the post op period was Fever
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