The ‘modified prone position’: a new approach for treating pre‐vesical stones with extracorporeal shock wave lithotripsy

Köse, Ahmet; Demirbaş, Murat

doi:10.1111/j.1464-410x.2003.04619.x

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…In our study, however, all subjects with stones 10 mm or larger achieved a stone-free status. This may be attributable to our new measures: we usually place patients in the contralateral prone position to potentiate the treatment effect on lower ureteral stones, in accordance with the report by Köse et al [12], and before ultrasonography we also apply jelly in a thin layer to the skin surface and to the area on the treatment table around the spot in contact with the skin to avoid exposure to air, thereby reducing minute air bubbles generated from the skin surface and minimizing attenuation of shock waves. ESWL seems to be an effective first-line treatment also in subjects who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, but it is sometimes difficult to treat stones greater than 10 mm by ESWL monotherapy.…”

Section: Discussionsupporting

confidence: 85%

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

et al. 2011

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BackgroundThe aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004.MethodsThe subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL) alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment.ResultsAt 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]). Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each.ConclusionsESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

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Section: Discussionsupporting

confidence: 85%

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

et al. 2011

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“…Our rate falls within the distal ureteral stone–free rate according to literature, which ranges from 53% to 96% [4, 7, 8]. Abdelghany et al 2011 [5] and Fayed et al, 2007 [6] reported a stone clearance of 84% and 88% respectively, of ESWL for lower ureteric calculi.…”

Section: Discussionsupporting

confidence: 68%

Management of lower ureteric stones: a prospective study

Etafy

Morsi

Beshir

et al. 2013

CEJU

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ObjectiveTo discuss the current concepts in lower ureteric stone management.Material and methodsBetween October 2008 and November 2010, 190 patients of both sexes and of different age groups with lower ureteric stones, underwent in situ extracorporeal shock wave lithotripsy (ESWL) (48 cases), ureterorenoscopy (URS) (120 cases) and open stone surgery (OSS) (22 cases).The patients’ clinical and radiological findings, as well as stone characteristics, were reviewed and correlated with the stone–free status.ResultsIn the ESWL group, the operative time was 43.13 +22.5 min; the average number of sessions/patients was 1.5 sessions; the average number of SW/patients was 4500 SW/patients; the average energy was 16.5 kV; the average stone burden was 7.8/mm; the overall stone–free rate was 75% (36/48); and the average radiation exposure time was 3.5 min.In the URS group, the operative time was 49.21 +16.09 min; the average stone burden was 10.81mm; the overall stone–free rate was 97.5% (117/120); the average hospital stay was 3.99 days; and the average radiation exposure time was 0.75 min.In the OSS group, the operative time was 112.38 +37.1 min; the overall stone–free rate was 100% (22/22); and the average hospital stay was 9.74 days.ConclusionIn the management of patients with lower ureteral stones, URS, SWL and OSS were considered acceptable treatment options.This recommendation was based on the stone–free results, morbidity and retreatment rates for each therapy.

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“…A number of studies suggested that ESWL can be regarded as the first treatment option for patients with lower ureteral stones compared with URSL [11,12,16], due to its noninvasive nature, fewer complications, faster convalescence, and shorter operative time. Several reports showed the suc-cess rates >90% in those patients performed ESWL [27,28]. By contrast, some papers reported that URSL had an advantage over ESWL in high stone free rate, reliable efficacy for the treatment of distal ureteric calculi [17,20,21].…”

Section: Commentmentioning

confidence: 94%

Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) versus Pneumatic Ureteroscopic Lithotripsy (URSL) for Lower Ureteral Stones Therapy in Asia: A Meta-Analysis

Li¹,

Fu²,

Ming³

et al. 2014

IJCM

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Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to identify and summarize randomized controlled trials that were used to treat distal ureteral stone. Methods: Eligible studies were identified from electronic databases. Database search, quality assessment, and data extraction were performed by two reviewers independently. Our primary outcome was the stone-free rate. Secondary outcomes were the fragmentation rate, complications and the rate of re-treatment and secondary procedures. The results were assessed by Review Manager 5.0. Publication bias was evaluated by Stata 11.0. Results: 13 trials were included. Meta-analysis of pooled data showed that pneumatic ureteroscopic lithotripsy demonstrated a significant advantage over extracorporeal shock wave lithotripsy (OR = 0.14, 95% CI [0.09, 0.23], P < 0.00001) in the stone-free rate; the extracorporeal shock wave lithotripsy had statistical disadvantages over pneumatic ureteroscopic lithotripsy in the fragmentation rate of ureteral stones (OR = 0.14, 95% CI [0.05, 0.39], P = 0.0002); and the rate of re-treatment and secondary procedure was lower in pneumatic ureteroscopic lithotripsy than in extracorporeal shock wave lithotripsy (OR = 5.37, 95% CI [2.61, 11.07], P < 0.00001). Our pooled results showed that there was no statistical difference between extracorporeal shock wave lithotripsy and pneumatic ureteroscopic lithotripsy in hematuresis, ureteral stricture and urosepsis or fever. Finally extracorporeal shock wave lithotripsy had a higher incidence of colic pain than pneumatic ureteroscopic lithotripsy. Conclusion: The present meta-analysis suggested that pneumatic ureteroscopic lithotripsy had large advantages over extracorporeal shock wave lithotripsy in the treatment of lower ureteral stones.

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The ‘modified prone position’: a new approach for treating pre‐vesical stones with extracorporeal shock wave lithotripsy

Cited by 14 publications

References 16 publications

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

Management of lower ureteric stones: a prospective study

Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) versus Pneumatic Ureteroscopic Lithotripsy (URSL) for Lower Ureteral Stones Therapy in Asia: A Meta-Analysis

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