Introduction: The aim of this study was to compare the efficacy and safety of shock wave lithotripsy (SWL) and flexible ureteroscopy (fURS) in treating unilateral moderate-sized (10-20 mm) kidney stones, with a focus on changes in quality of life (QoL).
Methods: This study included 112 patients with unilateral radiopaque kidney stones. Patients were divided into two groups: SWL (n = 64) and fURS (n = 48). Treatment outcomes, including QoL changes, were evaluated comparatively between the groups.
Results: Both groups were similar in terms of age, gender, stone size, and density. Short-term (4-week) stone-free rates (SFRs) were higher in the fURS group (79.17% vs. 51.56%, p = 0.003). However, at 3 months, there was no significant difference in SFRs (89.8% vs. 85.2%, p = 0.098). Pain levels, assessed using the Visual Analog Scale, showed no difference 1-h post-procedure (p = 0.338), but SWL had lower pain scores at 4 h (p = 0.002). QoL, assessed with the SF-36 questionnaire, indicated an advantage for SWL in energy/fatigue parameters (p = 0.017), with no significant differences in other domains. SWL was particularly beneficial for energy levels and emotional well-being.
Conclusions: SWL's noninvasive nature, reduced pain levels, and advantages in specific QoL parameters make it an effective treatment option for medium-sized kidney stones. While fURS offers better short-term stone clearance, SWL demonstrates comparable long-term efficacy with added QoL benefits.
Keywords: Flexible ureteroscopy; Kidney stones; Quality of life; Shock wave lithotripsy.
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