Percussion, diuresis, and inversion therapy for the passage of lower pole kidney stones following shock wave lithotripsy

Liu, Liang Ren; Li, Qi Jun; Wang, Qiang; Liu, Zhen Hua; Yang, Xu

doi:10.1002/14651858.cd008569.pub2

Cited by 27 publications

(24 citation statements)

References 21 publications

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“…So, if the treated kidney's function has deteriorated due to the obstruction, the dehydration hinders adequate urine flow around the stone [18]. Diuretics will increase urine flow and thus the probability of cavitation [19,20]; which means, pieces of the broken stone shell increase, and the centre of the stone is exposed to subsequent shockwaves allowing entry of urine through the broken surface, thus giving an adequate interface with the centre of the stone [15]. The size of the stone is an important prognostic factor for successful ESWL and is considered as a highly effective treatment option for lower pole stones ≤2 cm [21].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

Sohu

Soomro

Mangrio

et al. 2019

Arab Journal of Urology

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2019) Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial, Arab Journal of Urology, 17:4, 279-284, ABSTRACT Objective: To assess the effect of diuretics (furosemide) administered before extracorporeal shockwave lithotripsy (ESWL) followed by continuous infusion of 0.9% NaCl during the ESWL in patients with renal stones. Patients and methods: A tertiary care teaching hospital-based prospective randomised controlled trial was conducted from July 2015 to June 2017, including 714 patients who underwent ESWL. The patients were randomised in two groups: in Group-A, patients received 40 mg furosemide 30 min before each ESWL session and 1000 mL 0.9% NaCl intravenous hydration during the procedure. In Group-B, the patients only received 0.9% NaCl. All patients were followed-up every 2 weeks for 3 months with X-ray and ultrasonography of the kidney, ureter and bladder. Patients without a radio-opaque stone at follow-up were classified as successes. Results: After 2 months, the stone-free rate (SFR) was much higher in Group-A, at 77.0% vs 65.3% (P < 0.001). Further, for patients aged ≤40 years, the SFR was significantly higher in Group-A than Group-B, at 89.2% vs 71.4% (P < 0.001). The mean (SD) age of the patients was 34.4 (8.23) years. Amongst them, 441 (61.8%) were male and 273 (38.2%) were female. The mean (SD) stone size was 1.42 (0.21) cm in Group-A and 1.40 (0.20) cm in Group-B. Conclusion: We conclude that the efficacy of diuretics (furosemide) along with hydration is superior to hydration alone during ESWL for renal stone clearance.Abbreviations: BMI: body mass index; KUB: kidney, ureter and bladder; OPD: Outpatient Department; ESWL: extracorporeal shockwave lithotripsy; SFR, stone-free rate. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

Sohu

Soomro

Mangrio

et al. 2019

Arab Journal of Urology

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“…If the function of the treated kidney has deteriorated because of the obstruction, dehydration hinders adequate urine flow around the stone. Diuretics increase the probability of cavitation by increasing this urine flow 5. Providing diuresis during SWL seems to be beneficial in providing this deep penetration.…”

Section: Discussionmentioning

confidence: 99%

The combination of furosemide and intravenous hydration does not affect the success of shock wave lithotripsy in renal stone treatment: a prospective randomised single blinded trial

et al. 2015

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ObjectivesTo investigate the effect of furosemide given before shock wave lithotripsy (SWL) in patients with renal stones.MethodsTwo-hundred patients with renal stones measuring 6–20 mm in diameter were prospectively included in this study. The treatment group (n=100 patients) received 40 mg furosemide 30 min before SWL plus 1000 mL 0.9% sodium chloride, infused during the procedure. Standard SWL alone was used for the control group (n=100 patients). The effectiveness of SWL was compared between the two groups.ResultsNo statistically significant difference was found between the groups in age, stone size, Hounsfield units, urinary pH, stone density, average number of sessions, average number of pulses or mean energy used. The stone-free rate was 69% in the control group and 71% in the treatment group (p=0.758).ConclusionsAlthough it is an easy and safe application, no positive effects of furosemide and hydration were found.

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“…From the experience of SWL to lower pole stones, mechanical percussion in an inverted position with diuresis can aid the passage of stone fragments from the lower pole, 177-179 yet a Cochrane review suggested further well-designed and adequately powered studies should be carried out to inform clinical practice. 180 A contralateral head-down tilt position after fURS was shown to significantly improve the stone-free rates. 181 Transcutaneousfocused ultrasonic pulses were also shown to help post-lithotripsy patients to pass stones, although further study on the use of this technology is required before generalized clinical use.…”

Section: Complicationsmentioning

confidence: 93%

Updates in endourological management of urolithiasis

Teoh

2018

Int J of Urology

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Urinary stone disease, or urolithiasis, is a very common disease with increasing prevalence and incidence. With the advancement of endoscopic techniques, the treatment outcomes of ureteroscopy (or transureteral lithotripsy) and percutaneous nephrolithotomy are continuously improving. In recent years, there have been many new developments in the field, including new endoscopy design, more effective auxiliary tools, improvement in treatment protocols, introduction of robotic technology, combining both ureteroscopy and percutaneous nephrolithotomy (endoscopic combined intrarenal surgery or transureteral lithotripsy‐assisted percutaneous nephrolithotomy), improvement in laser technology, and so on. All these new inputs will further improve the treatment efficacy and safety of the procedures, thus benefiting our patients. In the present review, we briefly go through the main steps of ureteroscopy and percutaneous nephrolithotomy, with a concise description and application of these new advances.

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Percussion, diuresis, and inversion therapy for the passage of lower pole kidney stones following shock wave lithotripsy

Abstract: Percussion, diuresis, and inversion therapy for the passage of lower pole kidney stones following shock wave lithotripsy.

Cited by 27 publications

References 21 publications

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

The combination of furosemide and intravenous hydration does not affect the success of shock wave lithotripsy in renal stone treatment: a prospective randomised single blinded trial

Updates in endourological management of urolithiasis

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