Article Type

Original Study


Objective The aim of this study was to evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) with that of percutaneous nephrolithotomy (PCNL) for managing moderate-sized kidney stones measuring between 100 and 300 mm2 in area. Background Shock wave lithotripsy (SWL) is considered a standard treatment for patients with upper-tract stones that are less than 10 mm in diameter, whereas stones that are larger than 20 mm are best managed with PCNL. The management of stones between these sizes remains controversial. Our purpose was to review our contemporary series of SWL, ureteroscopy, and PCNL outcomes for intermediate-sized upper-tract calculi (100–300 mm2). Patients and methods This study was conducted at the Urology Department, Menoufia Teaching Hospital, Menoufia University, between December 2013 and February 2015. It study included all patients with moderate-sized renal calculi (range: 1–3 cm) who were planned for management of renal calculi either with PCNL or with ESWL. Patient data were taken as follows: (a) preoperatively, clinical assessment and laboratory investigations; (b) during surgery; and (c) postoperatively, complications and residual stone. Results This study included 70 patients with nonstaghorn calculi with an area between 100 and 300 mm. Thirty patients underwent PCNL and 40 underwent ESWL; 49 (70%) patients were male and 21 (30%) were female; 29 (41.4%) patients had right-sided stones and 41 (58.5%) had left sided stones. The mean age of the patients was 34.1 years and the average BMI was 29.0 kg/m2. The mean operative time in our study was 2.36 ± 0.8 h. Conclusion This study demonstrates that PCNL and up to two SWL treatments are safe and comparably effective in treating patients with intermediate-sized upper-urinary-tract stones between 100 and 300 mm2 in area.