257. Therapeutic effects of two lithotripsy procedures for upper ureteral calculi and their impact on patients' mental health

Abstract Background Upper ureteral calculi are calculi located in the ureteral segment between the renal outlet and the iliac vascular level. They can cause severe low back pain, hematuria, nausea, vomiting and other symptoms. In severe cases, they may lead to hydronephrosis or renal function damage. Common treatment methods include Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureteroscopic Lithotripsy (URS). However, there are differences between these two methods in terms of therapeutic effect and impact on patients' mental health. Therefore, this study analyzed and compared the therapeutic effects of these two types of lithotripsy and evaluated their impact on patients' mental health, with the aim of providing a certain theoretical basis for mental health guidance in the treatment of ureteral calculi. Methods A total of 100 patients with upper ureteral calculi were randomly selected for the study and divided into two groups, with 50 patients in each group. One group received ESWL treatment, and the other group received URS treatment. All patients underwent mental health assessments before and after treatment, including scores on anxiety and depression scales. The research results were compared through statistical analysis. Results The mental health impact results of each group under different treatment methods are shown in Table 1. As can be seen from Table 1, there are significant differences (p<.01) between the two groups of patients in terms of the stone clearance rate and recurrence rate after treatment. Among them, the stone clearance rate in the ESWL group was 85.7% and the recurrence rate was 10.2%. The stone clearance rate in the URS group was 94.0%, and the recurrence rate was 4.0%. In terms of mental health, the anxiety scores of patients in the ESWL group before and after treatment were 67.21 ± 5.42 and 51.12 ± 4.67 respectively, and the depression scores were 69.13 ± 5.01 and 54.33 ± 5.19 respectively. The anxiety scores of URS patients before and after treatment were 69.5 ± 5.48 and 47.32 ± 4.45 respectively, and the depression scores were 72.29 ± 6.27 and 53.39 ± 4.8 respectively. The above results indicate that the improvement in the URS group is more significant. Discussion The research results show that URS outperforms ESWL in terms of stone clearance rate and recurrence rate, and is more effective in improving patients' mental health. This might be because URS can remove stones more directly, reducing the patient's pain and anxiety. In addition, the rapid recovery of URS may help patients return to normal life more quickly, thereby improving their mental health. Future research can further explore the long-term impact of different lithotripsy procedures on patients' mental health and how to improve patients' quality of life through comprehensive treatment.