Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones

Abstract

BackgroundExtracorporeal shockwave lithotripsy (ESWL) is the management of choice for renal stones 20 mm or smaller, with a stone clearance rate of up to 89%. The purpose of the present is to investigate the efficacy of a commercialised ESWL service, being performed as an outsourced treatment using a mobile lithotripsy system on an outpatient basis. Furthermore, the study aims to evaluate the risk of needing treatment with an internal ureteral double-J stent (JJ) after ESWL treatment.MethodsDuring an eight-year period, 461 patients with a total of 589 renal stones were treated using a mobile lithotripsy system at a single Danish institution. A commercial company performed all treatments using a Storz Modulith SLK® system. Each stone was prospectively registered according to size, intra renal location and the presence of a JJ at the time of treatment. The number of required ESWL treatments and auxiliary procedures were retrospectively evaluated.ResultsThe success rate after the initial ESWL procedure was 69%, which increased to an overall success rate of 93% after repeated treatment. A negative correlation was found between stone size and the overall success rate (r = −0.2, p < 0.01). The upper calyx was associated with a significantly better success rate, but otherwise intra renal stone location was not predictive for treatment success. A total of 17 patients (2.9%) required treatment with a JJ after the ESWL procedure. No significant difference was observed between the stone size or intra renal location and the risk of needing treatment with JJ after ESWL.ConclusionsCommercialised ESWL treatment can achieve an overall success rate of more than 90% using a mobile lithotripsy system. As expected, an inverse relation between stone size and success rate was found. Patients who do not require treatment with a JJ prior to ESWL will only rarely need treatment with a JJ after ESWL, irrespective of stone size and intra renal stone location.

Evaluation the success rate of extra corporal shock wave lithotripsy (ESWL) in patients with urinary stones

“…These results are in line with other studies. [15][16][17][18][19] In the present study, 31% had stone in proximal urethra and 27% in the pelvic and 18% in lower calices which in terms of distribution of stone formation was in line with other studies. [20][21][22] In the present study, the average shock exposure was 3900 and in stones below 10 mm the stones in the upper calices were 100% successful while 66 % of the middle calices stones were completed and 16% had partial response and 16% had failure in treatment.…”

Efficacy and Predictive Factors of the Outcome of Extracorporeal Shock Wave Lithotripsy: A Review of One-thousand-nine-hundred-ninety- seven Patients

“…SWL has been recognized as a safe and non-invasive treatment method for ureteral stones smaller than 20 mm and uncomplicated kidney stones since its introduction in the 1980s. In most cases, SWL can be performed without anesthesia or with minimal anesthesia (7). Many studies have shown that factors such as stone size, skin-to-stone distance, severity of obstruction, obesity, urinary tract anatomy and the type of device used are effective in predicting SWL success.…”

Efficacy and Outcome of Extra Corporeal Shockwave Lithotripsy in the Treatment of Kidney and Upper Uretericstone: A Single Centre Experience

“…Serial X-rays KUB film and ultrasonogram and CT Scan KUB in selected cases were done to evaluate stone clearance status and to detect presence of steinstrasse. (fig [2][3][4][5][6][7][8] In this study the patients with no radiological evidence of stone were considered as complete clearance in follow up period of three months. Incomplete stone clearance or failed treatment assigned to patients with persistence stone of size more than 5mm, even after 3 sessions of ESWL.…”