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| Efficacy of URSL and PCNL in the Treatment of Upper Ureteral Impacted Calculi after Extracorporeal Shock Wave Lithotripsy Failure |
| CHEN Ye |
| Department of Andrology and Urology, Nanyang Second General Hospital, Nanyang Henan 473000 |
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Abstract 【Objective】 To investigate the clinical efficacy of minimally invasive ureteroscopic lithotripsy with holmium laser (URSL) and percutaneous nephrolithotomy (PCNL) in the treatment of patients with upper ureteral impacted calculi (UC-UU) after failure of extracorporeal shock wave lithotripsy (ESWL).【Methods】 A total of 108 UC-UU patients who failed ESWL were randomly divided into the URSL group and the PCNL group (54 cases each) using the parity method. The two groups were compared in terms of operative indicators, renal function parameters, inflammatory factor levels, surgical success rate, stone clearance rate, and postoperative complications.【Results】 The operative time in the URSL group was shorter than that in the PCNL group (P<0.05). There were no significant differences between the two groups in intraoperative blood loss and postoperative hospital stay (P>0.05). Compared with preoperative values, both groups showed decreased blood urea nitrogen (BUN) and serum creatinine (SCr) levels, whileinterferon γ (IFN-γ), interleukin-6 (IL-6), and interleukin-12 (IL-12) levels increased significantly after surgery (P<0.05), with the URSL group showing lower inflammatory factor levels than the PCNL group (P<0.05). The surgical success rate and the 2-week postoperative stone clearance rate were higher in the PCNL group than in the URSL group (P<0.05). There was no significant difference in the overall incidence of postoperative complications between the two groups (P>0.05).【Conclusion】 Both URSL and PCNL are safe and effective for the treatment of UC-UU patients after ESWL failure. Compared to PCNL, URSL can shorten operative time, improve renal function, and reduce inflammatory responses, whereas PCNL demonstrates higher surgical success and stone clearance rates.
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Received: 07 May 2023
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2025, Vol. 42 
