الفهرس 
ANATOMY OF URINARY SYSTEMOnly 14 pages are availabe for public view
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Abstract
R
enal stones one of the most common urological diseases which require active treatment due to its high prevalence, high recurrence rates, and various complications
There are many therapeutic approaches for the treatment that can achieve complete stone clearance with minimal patient morbidity.
A prospective randomized study was done on 138 patients to compare the results of Ultra minipcnl versus stented extracorporeal shock wave lithotripsy (ESWL) in treatment of renal stones regarding efficacy by stone free rate, the need for retreatment after both procedures, hospital stay and complication rate in Urology Department Unit, Ain Shams University.
Statistical analysis revealed the following:
There was no statistically significant difference between the groups regarding age, and sex.
In addition, there was no statistically significant difference between the groups regarding stone location, laterality, and size of the stone.
There was a highly statistically significant higher mean value in PCNL than ESWL regarding the time of the operation.
There is no statistically significant difference between Ultra mini PCNL group compared to stented ESWL group according to stone opacity.
Regarding the stone free, there was increased frequency in PCNL group were 37 patients (88.1%) than ESWL group were 32 patients (80%), but insignificant difference between groups.
Regarding the need for retreatments residual stone >3mm, there was increased frequency in ESWL group were 6 patients (15%) than PCNL group were 5 patients (11.9%), but insignificant difference between groups.
The results showed 12 patients were fever, out of them 7 patients (16.7%) in PCNL group and 5 patients (12.5%) in ESWL group, additionally there were 16 patients were hematuria, out of them 10 patients (23.8%) in PCNL group and 6 patients (15%) in ESWL group, while there was one case need for blood transfusion in ultra mini PCNL group.
A highly statistically significant higher mean value of hospital stay “days” in ultra mini PCNL group with ranged from 3-4 with (mean 3.26±0.45 days) than stented ESWL group ranged from 1-2 with (mean 1.18±0.38 days).
Receiver operator characteristics (ROC) curves were indices of stone size as predictors of need for retreatment in included patients. Stone size indices were significant predictors as need for retreatment, there was used to define the best cut off value of stone size which was ≥19, with sensitivity of 72.7% specificity of 47.9% positive predictive value of 37.9%, negative predictive value of 91.9% with diagnostic area under the curve of 0.598 [0.484-0.705].
from the above results, we concluded that both stented ESWL and Ultra-Mini-PCNL are reasonable treatment choices for renal stones less than 2 cm with low complication rates. Denying Ultra-Mini-PCNL from patients with medium sized stones for fear of complications is considered unwarranted. Stone size indices in our study were significant predictor for the need of retreatment.