Energy output modalities of shockwave lithotripsy in the treatment of urinary stones: escalating or fixed voltage? A systematic review and meta-analysis

He, Zihao; Deng, Tuo; Yin, Shanfeng; Xu, Zihao; Duan, Haifeng; Chen, Yeda; Duan, Xiaolu; Zeng, Guohua

doi:10.1007/s00345-019-03049-2

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…A shock wave frequency of 60-90 shock waves/min improves the stone-free rate (SFR), and tissue damage decreases with a low shock wave frequency (5,6). Recent studies recommend increasing the power step-by-step, as this ramping technique improves stone fragmentation and reduces renal injury during ESWL (7)(8)(9)(10)(11). Additionally, medical expulsive therapy (MET) is efficient for relieving pain and the passage of a stone (12); however, the types of shock waves generated by other methods are not successful (9).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of extracorporeal shock wave lithotripsy for ureteral stones according to ESWL intensity

Yoon¹,

Park²,

Kim³

et al. 2021

Transl Androl Urol

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Section: Introductionmentioning

confidence: 99%

Outcomes of extracorporeal shock wave lithotripsy for ureteral stones according to ESWL intensity

Yoon¹,

Park²,

Kim³

et al. 2021

Transl Androl Urol

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“…In another study in humans, no statistically significant difference was found between treatment protocols [10]. The latest metaanalysis in the literature reported that escalating voltage ESWL offers comparable safety and efficacy to constant voltage ESWL [28]. In their prospective randomized study of 150 patients, Rabah et al Compared constant, escalating and reduction energy ESWL protocols for renal stones.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Fixed and Ramping Voltage Extracorporeal Shockwave Lithotripsy with Acute Kidney Injury Biomarkers: Prospective Randomized Clinical Study

Şeker,

Atar,

Kural

et al. 2023

Grand J Urol

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Objective: To compare extracorporeal shock wave lithotripsy (ESWL) induced renal injury in patients undergoing different ESWL treatment protocols by measuring urinary tissue metalloproteinase-2 inhibitor (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) excretion. Materials and Methods: This prospective, randomized study was conducted between April 2016 and June 2016 in group 1 patients undergoing fixed voltage ESWL and group 2 patients undergoing ramping voltage ESWL. Urinary TIMP-2 and IGFBP7 levels were analyzed before ESWL and 2 hours after ESWL, and urinary beta-2-microglobulin (β2-MG) and albumin were analyzed before ESWL and 1 week after ESWL to assess renal injury. The primary outcome was to compare the effect of ESWL on early renal injury with biochemical markers in the different treatment protocols, and the secondary outcome was to compare the two treatment protocols in terms of stone free rate and complications. Results: There was no statistically significant difference between groups in terms of demographic and stone characteristics. There were statistically significant differences in serum creatinine and e-GFR at baseline and one week after treatment (p<0.05). There was no significant change in serum urea, urinary β2-MG and albumin levels before and after ESWL. There was a statistically significant increase in urinary TIMP-2, IGFBP7 and TIMP-2 x IGFBP7/1000 levels in both groups compared to baseline (p<0.05). There was no statistically significant difference in the rates of stone free and complications between the groups (p>0.05). Conclusion:In this prospective randomized study, we observed a significant increase in TIMP-2, IGFBP7 and combination levels after ESWL treatment in both groups, suggesting that these two biomarkers could be used to identify acute kidney injury due to ESWL. However, the comprehensive evaluation of clinical parameters and urinary markers did not differ in the rates of renal injury, success, and complications after ESWL in both protocols.

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“…Frequency of low shock wave reduces tissue injury and stone free rate was enhanced by shock wave frequency 60-90 shock wave per minute [5,6]. Recent research suggests gradually raising the power, since this ramping strategy increases stone breakup and decreases renal damage during ESWL [7][8][9]. Furthermore, medical expulsive treatment (MET) is effective for pain relief and stone passage; however, the types of shock waves generated by other procedures are ineffective [10].…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting the Outcome of Extracorporeal Shockwave Lithotripsy in Urinary Stone Treatment

Ahmad¹,

Rehman²,

Khan³

et al. 2022

PJMHS

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Background and aim: The recurrence of urinary stones occurs in two thirds of patients within a 20-year period, making urinary stones a common pathology. Among urology pathologies, kidney stones rank third behind urinary infections and conditions of the prostate. The present study intended to assess various factors affecting the extracorporeal shockwave lithotripsy (ESWL) outcome in urinary stone treatment. Methods: This cross-sectional study was carried out on 136 urinary stone patients who underwent extracorporeal shockwave lithotripsy in the Department of Urology, Sahiwal Teaching Hospital, Sahiwal for the duration from September 2021 to August 2022. Computed tomography confirmed the presence of stones and measured the size (3-20 mm), distance from skin to stone, location, and density in Hounsfield units. Patient’s characteristics such as estimated rate of glomerular filtration and BMI were measured. A successful ESWL requires at least a 3mm residual renal stone fragment in post-therapy, and at least a complete clearance of ureteric stones at the end of treatment. SPSS version 26 was used for descriptive statistic. Results: Of the total 136 urinary stone patients, there were 108 (79.4%) male and 28 (20.6%) females. The incidence of stones present in proximal ureter, mid, and distal ureter was 72 (52.9%), 7 (5.1%), and 57 (41.9%) respectively. All the patients underwent ESWL 1.5 times (average), and the success rate in first, second, and third session was 67.8% (n=92), 83.8% (n=114), and 91.2% (n=124) respectively. The overall success rate of ESWL was 80.9%. A multivariate analysis revealed that HU [OR=0.89, 95% CI, 0.96-0.98, P=0.001) and stone size [OR=0.79, 95% CI, 0.62-0.98, P=0.051] were significantly affecting the first ESWL session success rate. Third session success rate was significantly affected by stone size [OR=0.76, 95% CI, 0.58-0.95, P=0.015]. Stent associated higher failure rate [OR=6.425, 95% CI, 2.132-18.235, p=0.001] and ESWL failure was three-times higher in females than in male. Conclusion: The present study found that the overall success rate of ESWL in urinary stone treatment was 80.9%. ESWL success rates were affected by stone size and HU. Patients' pain and fragmentation levels should be considered when adjusting the intensity of ESWL. Keywords: Urinary stone treatment, Outcomes, Extracorporeal shockwave lithotripsy

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Energy output modalities of shockwave lithotripsy in the treatment of urinary stones: escalating or fixed voltage? A systematic review and meta-analysis

Cited by 4 publications

References 22 publications

Outcomes of extracorporeal shock wave lithotripsy for ureteral stones according to ESWL intensity

Outcomes of extracorporeal shock wave lithotripsy for ureteral stones according to ESWL intensity

Comparison of Fixed and Ramping Voltage Extracorporeal Shockwave Lithotripsy with Acute Kidney Injury Biomarkers: Prospective Randomized Clinical Study

Factors Affecting the Outcome of Extracorporeal Shockwave Lithotripsy in Urinary Stone Treatment

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