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

Abstract

Background: Urinary stones are one of the most common and earliest known human diseases. Extracorporeal shock wave lithotripsy (ESWL) is known as the most common method for treating urinary stones less than 20-25 mm. The aim of this study was to evaluation the success rate of ESWL in patients with urinary stones.Methods: In this cross-sectional descriptive study 200 patients with urinary stones between 7-25 mm which were candidates for lithotripsy, enrolled in the study. Patients with coagulation disorders, urinary or other organ transplantation, pregnant women, uncontrolled blood pressure patients, and those who are contraindicated for drug use have been excluded from the study. The process was carried out by an operator and by the Dornier Compact Delta II lithotriptor. Two weeks later, the patients were re-visited, and ultrasound was performed, and the success rate of stones was measured and recorded and classified in three groups complete response, partial response and failure in treatment. Collected data analysed by statistical methods in SPSS version 19.Results: Efficacy of Arian 101 lithotriptor in removing of renal stones, were found to be 74% complete response, 25.5% partial response while 0.5% of subjects had no response. There was significant positive correlation between the size of stones before and after lithotripsy (r=0.49, p=0.001). In stones upper than 10 mm, the upper calices stones had 100% complete response. Also, in stones lower than 10 mm, the upper calices stones had 100% complete response.Conclusions: The results showed that Dornier Compact Delta II lithotriptor has more efficacy in treatment of stones. In stones below 10 mm, the success rate of treatment was generally higher, especially in the upper calices stones and pelvic. In stones larger than 10 mm, the success rate was slightly lower, but in the case of upper calices stones, the complete response was 100%.

Effectiveness of Extracorporeal Shockwave Lithotripsy in Removing Small and Large Stones

“…14 Moreover, the study showed that the likelihood of successfully removing stones decreases as their size increases.which is corroborated by other studies which have found larger stones to be more resistant and require higher energy waves and multiple sessions for successful removal. [17][18][19] Additionally, studies suggest that larger stone sizes lead to an increased risk of hematuria and pain. This is in line with previous studies showed that that stone size is the most influential factor in predicting ESWL outcomes.…”

“…One recommended option is ESWL, which can be further improved by combining it with other treatments. 18 In a recent investigation by Cakiroglu et al 23 , shock wave lithotripsy (SWL) emerged as the preferred initial treatment for kidney stones, even those measuring less than 400mm in diameter. This is primarily due to SWL's non-invasive nature and its ability to effectively fragment stones into smaller pieces that can be passed through the urinary system.…”