Outcomes of Shockwave Lithotripsy for Upper Urinary-Tract Stones: A Large-Scale Study at a Single Institution

Abe, Teruo; Akakura, Koichiro; Kikuchi, Makoto; Ueda, T.; Ichikawa, Tomohiko; Itô, Haruo; Nozumi, Kuniyoshi; Suzuki, Kazuhiro

doi:10.1089/end.2005.19.768

Cited by 107 publications

(81 citation statements)

References 15 publications

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“…While staghorn is the extreme of large stone size, any stone over 2 cm is associated with an inferior outcome when treated with SWL [8][9][10][11] . Larger stones usually require more procedures and have increased complications such as obstruction from steinstrasse or larger fragment passage.…”

Section: Patient Selectionmentioning

confidence: 99%

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins

Matlaga

2015

WJN

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Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient-and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate. Core tip: Shock wave lithotripsy is a commonly utilized technology for kidney stone treatment that has declining efficacy over the past decade. The paper outlines how to optimize outcomes with proper patient selection and control of treatment parameters.

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Section: Patient Selectionmentioning

confidence: 99%

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins

Matlaga

2015

WJN

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“…Evaluation of the QoL scores during 3-month evaluation in all sub-groups these rates are reasonably lower (33-65%) in larger stones (20- (20-30 mm), while 46% of the cases became SF, 54% did still have RF during follow-up (11). Lastly "The American Urological Association Nephrolithiasis Clinical Guidelines Panel" data emphasized that the re-retreatment rates increases from 12% for stones < 10 mm up to 46% for stones > 30 mm (24).…”

Section: Figure 1bmentioning

confidence: 78%

“…Although ESWL is the management of choice for most stones with its efficient and safe natüre (2); studies demonstrated that despite an effective disintegration, sponta neous passage and in some cases removal of the fragments may be needed for a completely SF status. Long-term follow-up data in large number of patients has clearly shown that 23% to 54% of the cases undergoing ESWL may have residing fragments after this procedure (11,12). Regarding the clinical course after ESWL although majority of disintegrated stone particles may pass spontaneously or stay in situ asymptomatic; they may be symptomatic and/or obstructive in a certain percent of the cases.…”

Section: Discussionmentioning

confidence: 99%

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Stone size and quality of life: A critical evaluation after extracorporeal shock wave lithotripsy

Şahin

Çetinel

Eryıldırım

et al. 2015

Arch Ital Urol Androl

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Objectives: To evaluate the quality of life (QoL) of the patients after extracorporeal shockwave lithotripsy (ESWL) on a treated stone size related basis. Methods: 90 patients undergoing ESWL for kidney stones were divided into three groups; Group 1 (n: 30, ≤ 10 mm), Group 2 (n: 28, 11 mm-≤ 20 mm) and Group 3 (n: 32, 20-25 mm). During 3-months follow-up, outcome of the procedure, number of cases with emergency department visits, analgesic required, re-tretatment rates, additional procedures and the changes in the QoL were evaluated. Results: the number of emergency department visits and mean analgesic need; re-treatment rates and additional procedures were significantly higher in Group 3. Evaluation of the QoL scores in three groups showed that cases with larger stone still had lower scores during 3-month evaluation. Conclusions: Stone size could help us to predict the possible impact of ESWL on the QoL and depending on the size of the stone treated, a well planned indication and effective management possibly by an experienced urologist could limit the changes in the QoL of the patients.

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“…ESWL is preferred for the lithotripsy of renal calculi between 4 mm and 20 mm in diameter, and is less successful for the fragmented ureteral stones [12]. MPCNL is a modified version of PCNL that has been used extensively in China over the past two decades [15].…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Kidney Stone

Li¹,

Li²,

Yuanyuan³

2016

Proceedings of the 2016 International Conference on Biomedical and Biological Engineering

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Abstract. We examined the surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL) in complicating urolithiasis.10 patients were hospitalized for MPNCL due to upper tract urolithiasis. Calyx puncture was performed in the prone position under ultrasonographic guidance. The renal access route was established using a set of 8F-12F dilators, and a transpyelic ballistic lithotriptor was used to fragment calculi. The entire operative time was approximately 40-60 min, and the mean time of establishing percutaneous access was 20 min. The calculi were completely removed by single-session pneumatic lithotripsy. The 10 patients recovered from MPCNL uneventfully, and the follow-up radiological examinations identified no stone residual or recurrence.MPCNL is a minimally invasive modality that is effective and safe for the treatment of urolithiasis in patients.

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Outcomes of Shockwave Lithotripsy for Upper Urinary-Tract Stones: A Large-Scale Study at a Single Institution

Abstract: Treatment with SWL has a low morbidity and high effectiveness. The number and location of stones and a history of urolithiasis significantly influence recurrence. Further studies of prophylactic therapy are required, especially for patients with these factors.

Cited by 107 publications

References 15 publications

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Stone size and quality of life: A critical evaluation after extracorporeal shock wave lithotripsy

Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Kidney Stone

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