Authors
Muhammad Waqas Arshad, Atif Javed, Shafeullah Ahadi, Azhar Ghayoor Yousaf
Published in
Pakistan journal of medical sciences. Volume 42. Issue 9. Pages 2581-2587.
Abstract
To compare outcomes of extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS) for renal stones measuring 1-2 cm, including stone clearance, hospital stay, hematuria, sepsis, postoperative pain, and retreatment.
Six months, single-center, open-label, parallel-group randomized controlled trial was conducted at the Department of Urology, Dr. Ziauddin Hospital, North Nazimabad, Karachi, from September 5, 2025 to March 4, 2026. Ninety-eight eligible adults were enrolled consecutively and randomized 1:1 to ESWL or RIRS by lottery method using concealed identical allocation slips. Non-contrast CT-KUB was performed at baseline and at 28 days. Pain was assessed by VAS at 24 hours. Data were analyzed using SPSS version 26, with p<0.05 considered significant.
Baseline characteristics were comparable between the treatment groups. Stone-free status after one session was 53.1% with ESWL and 85.7% with RIRS (RR 1.62, 95% CI 1.21 to 2.15; p<0.001), while 28-day stone clearance was 67.3% and 85.7%, respectively (RR 1.27, 95% CI 1.02 to 1.60; p=0.032). ESWL was associated with shorter hospital stay (p<0.001). Median VAS pain score at 24 hours was higher after ESWL [4 (IQR 3-4)] than RIRS [3 (IQR 2-4); p<0.001]. Retreatment was more frequent after ESWL (30.6% vs 10.2%; RR for RIRS vs ESWL 0.33, 95% CI 0.13 to 0.85; p=0.012), while gross hematuria and postoperative sepsis were comparable.
RIRS provided higher clearance and lower retreatment and pain scores than ESWL, while ESWL was associated with shorter hospital stay. Registration Number: www. clinicaltrials.gov (NCT07261995).
PMID:
42819572
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.
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