HWN Suggests

Doctors Take Aim At Epidemic Kidney Stones With Lasers

Lasers are becoming the treatment-of-choice for kidney stones in academic medical centers like the Mass General. Another alternative is so-called shock-wave lithotripsy, in which a machine uses high-energy sound waves to smash stones. The advantage is that it's noninvasive, that is, it doesn't require putting any equipment into the body. Sacco says she likes the precision of laser scopes. "I can see what I'm doing; I can tell how big my fragments are," she says. And there's a better chance of rendering patients stone-free with a single treatment.

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Articles of Interest

Extracorporeal shock wave lithotripsy versus flexible ureterorenoscopy in the treatment of untreated renal calculi

Treatment success was mainly dependent on stone size and treatment modality. URS might be the better treatment option for previously untreated kidney stones 5–20 mm, with similar morbidity but higher stone-free rates and fewer reinterventions than ESWL.

Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis

Urinary stones >2 cm are traditionally managed with percutaneous nephrolithotomy (PCNL). Recently, flexible ureteroscopy and laser lithotripsy) (FURSL) has been used to manage them with comparable results.

Is flexible ureteroscopy and laser lithotripsy (FURSL) the new gold standard for paediatric lower pole stones:

Flexible ureteroscopy and lasertripsy achieves excellent outcomes for treatment of paediatric LPS. While some patients might need a second procedure for complete stone clearance, FURSL may be considered as the first-line treatment of lower pole stones.

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi

Endoscopic lithotripsy is well tolerated in completely bedridden patients and is associated with a high success rate, even when there are severe comorbidities and a relatively large stone burden.

Ureteroscopic lithotripsy as day care procedure: Our early experience in Regional Institute of Medical Sciences

Recent advances in endourology and utilization of shock wave physics in urological stone disease have changed the management of urolithiasis altogether. With the emergence of fine ureteroscopes, intracorporeal lithotripsy with ureterorenoscopy has emerged as treatment of choice for ureteric (especially mid and lower) stones.

Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis

There is limited evidence to suggest that URS is less expensive than SWL. However, due to lack of standardization, studies seem to be contradictory and further randomized studies are needed to address this issue.

Ureteroscopy vs. shock wave lithotripsy: Advances spell positive future for both

We’re in an endoscopic epoch of urology. In training programs now, urologists are being exposed to endoscopic surgical approaches much earlier than they were years ago. Flexible ureteroscopy has gone from being commonly performed at the chief resident level to being commonly performed at the junior resident level. The residents have much more robust experience with endoscopic surgery in the course of their training program, at least in the United States, such that as they finish, they oftentimes have performed many more ureteroscopic stone cases than they have shock wave lithotripsy procedures.

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

In this paper, the relative benefits and harms of the two most commonly offered treatment options for urinary stones located in the upper ureter were reviewed. We found that both treatments are safe and effective options that should be offered based on individual patient circumstances and preferences.