Comparison of Patient Satisfaction with Treatment Outcomes between Ureteroscopy and Shock Wave Lithotripsy for Proximal Ureteral Stones
이종현, 우승효, 김은탁, 김대경, 박진성,
소속 상세정보
이종현 ( Lee Jong-Hyun )
을지대학교 의과대학 비뇨기과학교실
우승효 ( Woo Seung-Hyo )
을지대학교 의과대학 비뇨기과학교실
김은탁 ( Kim Eun-Tak )
을지대학교 의과대학 비뇨기과학교실
김대경 ( Kim Dae-Kyung )
을지대학교 의과대학 비뇨기과학교실
박진성 ( Park Jin-Sung )
을지대학교 의과대학 비뇨기과학교실
KMID : 0358320100510110788
Abstract
Purpose We examined patient satisfaction with treatment outcomes after shock wave lithotripsy (SWL) and ureteroscopic removal of stone (URS) for proximal ureteral stones.
Materials and Methods We evaluated 224 consecutive patients who underwent SWL (n=156) or URS (n=68) for a single radiopaque proximal ureteral stone. Stone-free rates, defined as no visible fragment on a plain X-ray; complications; and patient satisfaction were compared. Patient satisfaction was examined through a specifically tailored questionnaire that included overall satisfaction (5 scales) and 4 domains (pain, voiding symptoms, cost, and stone-free status).
Results The stone-free rates after the first, second, and third sessions of SWL were 36.5%, 65.4%, and 84.6%, respectively. The overall stone-free rate of URS was 82.4%, which was comparable to that of the third session of SWL. Complications were similar between the two groups except for greater steinstrasse in the SWL group. Overall satisfaction and voiding symptoms, cost, and stone-free status showed no significant difference between the groups. In the pain domain, the SWL group had a relatively lower satisfaction rate than did the URS group (p=0.05). Subanalysis showed that the satisfaction rate of the URS group with stone-free status was significantly lower than that of the SWL group in patients with ≥10 mm stones (p=0.032).
Conclusions Overall treatment outcomes and patient satisfaction were not significantly different between SWL and URS. However, patients undergoing URS for ≥10 mm proximal ureteral stones had lesser satisfaction with stone-free status, because of relatively lower stone-free rates due to upward stone migration. We suggest that factors regarding the subjective satisfaction of patients be included in counseling about treatment options for proximal ureteral stones.
키워드
Lithotripsy; Patient satisfaction; Ureteral calculi; Ureteroscopy
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