الفهرس 
Anatomy of the Urinary TractOnly 14 pages are availabe for public view
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Abstract
Objective: To compare between roles of extracorporeal shock wave lithotripsy (ESWL) versus laser lithotripsy (URS) in efficacy in treatment of upper ureteral stones ≤ 1 cm.
Patients and methods: 90 (ninety) patients aged from 18-80 years with upper ureteric stones ≤ 1 cm were treated in our Ain Shams University hospitals. Patients were randomly divided into two groups: group A (45 patients) who underwent laser URS which was divided into 2 subgroups A1:22 patients underwent F-URS and A2:23 patients underwent R-URS and group B (45 patients) who underwent ESWL.
Results: In group A, the SFR was 38/45 (84.4%) and in group B it was 25/45 (55.6%) (P = 0.006) after 1st session of ESWL, 33/45 (73.3%) (P = 0. 303) after 2nd session and 35/45 (77.8%) (P = 0.596) after 3rd session. A total of 7 auxiliary procedures in group A and 10 in group B were needed to reach a 100% SFR (P = 0.014). operative time , hospital stay and need for DJ application were significantly higher in group A than group B (P = 0.028, <0.001 and 0.046) respectively .There were no significant differences between the two groups for number of complicated cases, patients’ characteristics, or stone demographics (P = 0.65, P = 0.23,P = 0.77, and P = 0.62, respectively).
Conclusion: Both ESWL and Holmium laser lithotripsy (flexible and rigid ureteroscopy) for upper ureteric stones had high stone free rate and low incidence of complications.
Holmium laser lithotripsy had higher initial stone rate than ESWL which become comparable with repeated sessions of ESWL, but with longer hospital stay time, higher cost and need for anesthesia.but ESWL is still accepted as a practical and non-invasive first-line treatment method in the majority of cases because of its high success rates with advantage of outpatient procedure with no need of anesthesia.