Introduction Inflammation can arise as a consequence of both extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) treatments. Alterations in inflammatory parameters may serve as indicators of kidney injuries and the ensuing inflammation. This study aims to investigate the effects of ESWL and URS procedures on inflammatory parameters for proximal ureteral stone treatment. Materials and methods A prospective interventional study comprised 120 patients with confirmed stones measuring less than 10 mm in the upper half of the proximal ureter. These patients were randomly assigned to either the ESWL or URS treatment groups. Laboratory analyses encompassed interleukin-6 (IL-6), leukocyte count, fibrinogen levels, and erythrocyte sedimentation rate (ESR), which were assessed prior to the intervention, on the first postoperative day, and six months later. IL-6 levels in the serum were determined using a chemiluminescence immunoassay (CLIA). Results There was no significant difference in IL-6 levels between pre-intervention and the first post-intervention day in patients treated with ESWL (1.8 (1.4-2.59) pg/mL vs. 2.33 (1.22-3.19) pg/mL). However, for patients treated with URS, the pre-intervention IL-6 value was 2.9 (1.9-3.34) pg/mL, and it increased significantly to 7.1 (3.85-28.07) pg/mL on the first post-intervention day (p<0.001). On the first post-intervention day, levels of IL-6, CRP, leukocyte count, and ESR were significantly higher in patients treated with URS compared to ESWL (p<0.001; p<0.001; p=0.03; p=0.03, respectively). Conclusion Our research findings suggest that monitoring IL-6 levels can offer valuable insights into the degree of inflammation and tissue damage during and following observed procedures, particularly among patients undergoing URS, even within the initial days post-procedure.

Background: Bleeding and hematuria can be a consequence of both ESWL and URS treatment.Changes in hematological parameters may be indicative of bleeding events.Objective: The aim of the present study was to explore the hematological parameters after ESWL and ureterorenoscopy for the treatment of kidney stones. Methods: A prospective study included patients (120) with verified ureterolithiasis <10 mm in the upper half of the proximal third of the ureter. Patients were divided into two groups using the random sample method for the application of active stone removal methods ESWL or URS with contact disintegration.Patients were evaluated with routine hematological, biochemical blood parameters, and non-contrast enhanced computed abdominal tomography (CT) before the procedure.Routine laboratory analyzes were performed using standard methods and included determination of the number of erythrocytes, platelets, hemoglobin, hematocrit, glucose, INR, APTTwhich were measured preintervention, the first postoperative day and six months after the intervention. Results: The preintervention hemoglobin value in patients with urolithiasis treated with URS treatment was 140 g/L (136.2–155.7), and was statistically significantly higher compared to the measurement on the first post-intervention day [137.5 g/L (127, 2–156.7) (p<0,05)], as well as in relation to the measurement after six months [139 g/L (134.2–151.7), (p<0,05).The pre-interventional hematocrit value in patients with urolithiasis treated with URS treatment was 0.42 (0.41–0.47), but it dropped statistically significantly on the measurement on the first post-intervention day to a value of 0.41 (0.38–0, 47) (p=0.003). The hematocrit value after six months was 0.44 (0.41–0.47) and was statistically significantly higher compared to the pre-intervention measurement (p=0.002), as well as compared to the measurement on the first post-intervention day (p< 0.001). The pre-intervention INR value in patients with urolithiasis treated with URS treatment was 0.90 (0.86–1.1), and on the first post-intervention day, it increased statistically significantly to a value of 0.99 (0.89–1.1), (p=0.005).The INR value after six months continued to grow to a value of 1.02 (0.96–1.2), which was statistically significantly higher compared to the INR value measured on the first post-intervention day (p<0.001), as and in relation to the INR value measured before the intervention (p=0.007).Conclusion: The results of this study, in terms of hematological parameters, showed more favorable outcomes in patients treated with ESWL compared to URS lithotripsy. Significantly lower hemoglobin values six months after URS treatment, as well as a decrease in the number of platelets on the first postoperative day, lead to the conclusion that URS lithotripsy, which represents a more aggressive method compared to ESWL, may have less favorable consequences for patients.

ABSTRACT Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter.