Comparison of the Intracorporeal Ultrasonic Lithotripsy and Intracorporeal Pneumatic Lithotripsy in Terms of Stone Removal and Postoperative Complications

Mohammad Ayub; Shah Jahan; Fiaz Ahmad Tauqeer; Faisal Masoud; Ijaz Siddiqui; Muhammad Nazir

doi:10.29054/apmc/2020.1029

Mohammad Ayub Associate Professor, Department of Urology, PGMI / AMC / Lahore General Hospital, Lahore Pakistan
Shah Jahan Assistant Professor, Department of Urology, FJMU / Sir Ganga Ram Hospital, Lahore Pakistan
Fiaz Ahmad Tauqeer Senior Registrar, Department of Urology, Pakistan Kidney and Liver Institute, Lahore Pakistan
Faisal Masoud Senior Registrar, Department of Urology, Lahore General Hospital, Lahore Pakistan
Ijaz Siddiqui Senior Registrar, Department of Urology, Lahore General Hospital, Lahore Pakistan
Muhammad Nazir Professor & Head, Department of Urology, Hemodialysis & Kidney Transplantation, PGMI/AMC/ Lahore General Hospital, Lahore Pakistan

DOI: https://doi.org/10.29054/apmc/2020.1029

Keywords: Lithotripsy, Intracorporeal ultrasonic, Pneumatic lithotripsy, Stone clearance

Abstract

Background: Urolithiasis is the most common and painful urological disease. Intracorporeal lithotripsy has high success rate in management of ureteric stone. Objective: To do comparison of the intracorporeal ultrasonic lithotripsy and intracorporeal pneumatic lithotripsy in terms of rate of stone removal and post-operative complications. Study Design: Randomized Control Trial. Settings: Department of Urology, Lahore General Hospital, Lahore Pakistan. Duration: Six months from September 01, 2015 to February 29, 2016. Methodology: Total sixty patients were selected fulfilling the inclusion criteria into 2 groups. In group A, 30 patients were selected for intracorporeal ultrasonic lithotripsy and in group B, 30 patients were selected for intracorporeal pneumatic lithotripsy. In both groups all patients were compared in terms of rate of stone removal and postoperative complications then results were analyzed by SPSS 21. Results: Mean stone size in group A (Ultrasonic lithotripsy) was 1.13 ± 0.17 cm and in group B (Pneumatic lithotripsy) was 1.14 ± 0.18 cm. At first week after procedure, in group A 25(83.33%) and in group B 21(70%) of the cases had stone clearance, at 2^nd week after procedure a total of 26(86.66%) in group A and 24(80%) cases in group B had stone clearance. At 3^rd week after procedure there were 28(93.33%) cases in group A and 27(90%) cases in group B had stone clearance. The stone clearance in both groups at each follow up was statistically insignificant, p-value > 0.05. At 1^st week, in group A 3(10%) cases and in group B 6(20%) cases had pain, at 2^nd week after procedure there were 1(3.33%) cases in group A and 3(10%) in group B who reported pain and at 3rd week after procedure there were 1(3.3%) case in each group had pain. The pain at each follow up was statistically same in both groups, p-value > 0.05. According to complications, in group A and group B, 2(6.66%) and 3(10%) cases had fever, 3(10%) and 4(13.33%) had infection respectively. Only one case (3.3%) had retention of urine. All complications were statistically same in both groups, p-value > 0.05. Conclusion: Through the findings of this study we conclude that both intracorporeal pneumatic lithotripsy and intracorporeal ultrasonic lithotripsy are equally effective and had fewer complications. However, the ultrasonic procedure had higher rate of stone removal at each follow up (but difference was insignificant with similar morbidity compared to pneumatic devices.