Özet:

To evaluate the effectiveness of extracorporeal shock wave (ESWL) and ureteroscopy (URS) in the treatment of upper ureteral stones and the factors that may affect the success. Methods: The data of 233 patients treated with the diagnosis of upper ureteral stones were analyzed retrospectively. Patients were divided into two groups according to ESWL (Group 1) and URS (Group 2) treatment. All patients were evaluated by non-contrast abdominal computed tomography. The factors such as age and sex, body mass index, stone size, average stone density, skin-stone distance were recorded and their effects on treatment success were evaluated. Results: The average age of the patients was 47.4 years and the average body mass index was 25.9 kg/m2.The average stone size was 119.7 mm3 and the average stone density was 690. The 5 Hounsfield Units. 76.4% of the patients had hydronephrosis. Stone-free status was detected in 55.2% patients in the group 1, while it is 74.1% in the group 2. Female gender, stone size and skin distance were predictive factors for ESWL success. No predictive factor was detected for URS. The risk of failure was 13 times higher than those with shorter stone skin lengths greater than 10 cm (p <0.001). In addition, when the stone volume increased by 1 unit, the risk of failure increased by 1-fold (p = 0.009). In the URS group, it was observed that any parameter did not affect statistical success. Conclusion: This study showed that URS had a higher stone-free rate compared to ESWL in patients with upper ureteral stones. URS requires more hospital stay and more surgical instruments. Otherwise, the need for secondary treatment is higher in patients undergo ESWL.

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