Extremely slow, half-number shockwave lithotripsy for ureteral stones

Abstract

To elucidate and compare the treatment success rate and safety of the reduced (30 shocks/min with 1,200 shocks/session) and standard protocols (60 shocks/min with 2,400 shocks/session) of extracorporeal shockwave lithotripsy (SWL) for ureteral stones treatment. Materials and MethodsThis study was a retrospective review of 2410 SWL procedures with reduced or standard protocols (groups R and S) in 1106 patients for ureteral stones between March 2014 and March 2021. The patients chose either group after hearing an explanation of both protocols. The primary outcome was treatment success, de ned as the absence of residual fragments on ultrasonography and plain radiography within 30 and 90 days. A multivariate logistic regression and propensity score matching analysis evaluated the association between the reduced protocol and treatment success. ResultsThis study included 311 and 544 patients in the reduced (R) and standard (S) protocol groups, respectively. The patient's characteristics were comparable, excluding the lithotripter machine. There was no signi cant difference between groups R and S in treatment success rates within 30 (63.3% vs. 65.8%, p = 0.50) and 90 days (88.7% vs. 91.5%, p = 0.18). The overall complication rates did not differ signi cantly between the groups (p = 0.45). The multivariate analysis indicated no signi cant association between reduced protocol and treatment success within 30 and 90 days (p = 0.44 and p = 0.68, respectively). Propensity score matching showed no signi cant difference in the treatment success rates within 30 and 90 days or overall complication rates. ConclusionThe Extremely slow, half number protocol outcomes are comparable to those of the standard protocol for treating ureteral stones.

Role of Patient Age and Stone Density in Predicting Outcomes of Shockwave Lithotripsy in Lower Ureteral Stones

“…Furthermore, recent attempts to improve outcomes in SWL have involved modulating the treatment settings. One such approach involved reducing the frequency and number of shocks by half, but unfortunately, it did not yield promising results ( 14 ). Additionally, it has been observed that a shorter time interval between the onset of an obstructing stone and SWL treatment can increase the success rate in these complicated cases ( 15 ).…”

Development and validation of a predictive model for double-J stent encrustation after upper urinary tract calculi surgery

“…Double-J tube (ureteral stent tube) has been widely used in ureteral obstructions such as urinary stones, urinary system tumors, and ureteral stenosis. It can play an essential role in draining urine and supporting the urethra [ 1 – 3 ]. Upper urinary tract stones include renal stones and ureteral stones, accounting for more than 95% [ 4 ].…”