Can intervals in extracorporeal shock wave lithotripsy sessions affect success in the treatment of upper ureteral stones?

Abstract

IntroductionManaging upper ureteral stones with shock wave lithotripsy (SWL) has been done for many years. However, no conclusive data have been found on the intervals required between repeated SWL sessions.AimTo identify the most optimal intervals between SWL sessions.Material and methodsBetween September 2015 and December 2016, 80 patients undergoing elective outpatient lithotripsy who required repeated SWL sessions for ureteral stones were evaluated. These patients were categorised into two groups according to different SWL session intervals. The intervals between SWL sessions (n = 40) for the first group lasted one day, whereas those for the second group (n = 40) lasted 1 week. The data recorded during SWL included visual analogue scale (VAS) scores, total number of shocks, total energy used and number of sessions. The stone clearance rates, number of urinary tract infections, complication rates and VAS scores were compared between the two groups.ResultsAll patients’ clinical outcomes after SWL therapy are shown in Table I. The stone clearance rate for group 1 was 70%, whereas that for group 2 was 72.5% (p = 0.805). Additionally, the number of urinary tract infections, complications and VAS scores were similar for both groups. In group 1, 3 patients had steinstrasse, two suffered from severe renal colic, and one had a urinary tract infection. In group 2, 3 patients endured steinstrasse, and 2 patients experienced severe renal colic during the study.ConclusionsShort-interval SWL sessions are safe and effective for treating upper ureteral stones, and such sessions do not increase complication rates.

Risk factors for ureteroscopic lithotripsy: a case-control study and analysis of 385 cases of holmium laser ureterolithotripsy.

“…Ureteroscopic lithotripsy (URL) has become the first choice for the treatment of middle and lower ureteral stones due to its safety and effectiveness [6]. Short-interval shock wave lithotripsy sessions are safe and effective for treating upper ureteral stones [7]. Because of its precision and strong decomposing power, the holmium laser has become one of the most popular tools in urological procedures, including lithotripsy [8,9].…”

Comparison of shock wave lithotripsy and ureteroscopy in patients with proximal ureteral stones under the COVID-19 pandemic

“…The main reasons that accounted for these discrepancies were that the patients were treated with an early second session SWL protocol under real-time ultrasound localization. This protocol significantly improved the effectiveness of fragmentation and subsequently enhanced the SFR [ 17 ]. In addition, the retrospective design and small sample size also limited validation of the results.…”

“…Ultrasound localization not only provides real-time monitoring without X-ray exposure but is also suitable for both radiopaque and radiolucent stones. In addition, adding an early second SWL session significantly improved stone fragmentation, facilitated stone passage, and lower complication rate and cost [ 15 , 17 ]. Therefore, based on a large prospective cohort using a propensity score matching (PSM) method, we compared the effectiveness, safety, and cost between electromagnetic SWL guided by ultrasound with the early second session protocol and URS in patients with proximal ureteral stones.…”