Extracorporeal Shock Wave Lithotripsy in Management of Urolithiasis

Hamal, Bhairab Kumar; Bhandari, Bharat Bahadur; Thapa, Narayan

doi:10.3126/jpahs.v1i1.13007

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…The stone-free rate for upper, middle, and lower calyx was 77.8% (n=24), 75.0% (n=27), and 66.6 (n=4), respectively, while for pelviureteric junction and upper ureteric stones, it was 88.2% (n=15) and 81.8% (n=27). This was consistent with the study by Hamal et al, which reported 85.9%, 90.25%, and 50.5% success rates for the upper, middle, and lower calyx, respectively [12].…”

Section: Outcomesupporting

confidence: 93%

Prospective Evaluation of Extracorporeal Shockwave Lithotripsy in Renal and Upper Ureteric Stone Treatment: Clinical Assessment and Results

Singh,

Agarwal,

Sarpal

2024

Cureus

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Introduction: Extracorporeal shockwave lithotripsy (ESWL) is a widely accepted non-invasive treatment for renal and upper ureteric stones smaller than 2 cm due to its safety and efficacy. Despite advancements in minimally invasive techniques, extracorporeal shockwave lithotripsy remains an important modality. Aims and objective: This prospective observational study aimed to evaluate the outcomes of ESWL in managing renal and upper ureteric stones measuring less than 2 cm in terms of stone clearance. Material and methods: In a study conducted at a university-affiliated tertiary care hospital, 119 patients with renal and upper ureteric stones underwent extracorporeal shockwave lithotripsy over a 12-month period. Data on patient demographics, stone characteristics, treatment procedures, and complications were collected. Follow-up assessments were performed at two-week intervals for up to two months post-treatment. Results: The mean age of patients was 39.78 years, with a mean stone size of 1.2 cm. Right kidney stones were more prevalent (61.3% [n=76]). Complications included fever (19.3% [n=23]), gross haematuria (24.3% [n=29]), and steinstrasse (21.8% [n=26]). The success rate of extracorporeal shockwave lithotripsy was 81.5% (n=97), with 18.5% (n=22) of patients requiring surgical intervention due to incomplete fragmentation or residual fragments >4 mm. Stone size and density played significant roles in treatment success. Conclusion: Despite advancements in minimally invasive techniques, ESWL retains its significance as a noninvasive and effective treatment option for renal and upper ureteric stones smaller than 2 cm. Its success depends on various factors, including the stone site, size, and composition. ESWL offers advantages such as minimal morbidity, shorter hospital stays, and better patient compliance. Complications such as steinstrasse are manageable with conservative measures or ancillary procedures. While ESWL may be losing ground in some cases, its noninvasive nature and favourable outcomes make it a valuable option in the armamentarium for stone management.

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Section: Outcomesupporting

confidence: 93%

Prospective Evaluation of Extracorporeal Shockwave Lithotripsy in Renal and Upper Ureteric Stone Treatment: Clinical Assessment and Results

Singh,

Agarwal,

Sarpal

2024

Cureus

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“…This finding is consistent with the other reported studies in the literature on stone clearance rate of 56-96%. [11][12][13][14] The stone clearance depends on size, density, location, sessions of ESWL, types of lithotripters, dedicated services setups, use of adjunctive measures like PID (percussion, inversion, and diuresis), and radiological confirmation during and after the treatment.…”

Section: Discussionmentioning

confidence: 99%

“…8 The ESWL service started in Nepal in 1987 at Shree Birendra Hospital-Nepal Army Institute of Health Sciences and reported a stone clearance of 73.52% (522/710) during a 10 y period from 2002 to 2012. 11 Other centers have reported a clearance of 79.3% (341/430) increasing to 96.3% (414/430) after multiple sessions, 12 and yet another study 13 found clinically significant residual fragments in 1/3 rd of 34 cases of ESWL after 3 mo.…”

Section: Introductionmentioning

confidence: 92%

Outcome of extracorporeal shock wave lithotripsy for renal and upper ureteric stone clearance

Regmi

Adhikari

Chapagain

et al. 2022

J Patan Acad Health Sci

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Introduction: Extracorporeal shockwave lithotripsy (ESWL) is a day care, less invasive procedure not requiring anesthesia for the treatment of renal and ureteric stones. Method: This was a cross sectional study of retrospectively collected data on ESWL during May 2018 to January 2020 at the department of Urology, Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal. The data on ESWL for renal and upper ureteric stone up to the size of 20 mm were included. Stone clearance was defined as stone fragment <4 mm on kidney ureter bladder (KUB) X-ray or ultrasonography (USG) during follow up at 1 - 3 mo. Ethical approval was obtained from NAMS ethical committee. Microsoft Excel was used for descriptive analysis of age, gender, stone size, density, location, hydronephrosis, and clearance. A Chi square test was used for association, and a p-value <0.05 considered statistically significant. Result: Out of 79 cases, overall stone clearance was 48(60.8%), 100% for <10 mm (14/14) and density <500 HU (5/5), and 80% for upper ureteric stone (4/5) and 74.1% for those without hydronephrosis (20/27). Patients in age group of 20-39 y accounted for 48(60.8%), males 52(65.8%), 52(65%) had 10-15 mm stones, 46(58.2%) in pelvis, 48(60.8%) density of 751-1000 HU, and mild hydronephrosis present in 44(55.7%). Conclusion: Stone clearance were highest (100%) for small stone <10 mm size and low density <500 HU. The stone clearance rate decreased as the size, density, and hydronephrosis increased.

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Impact of Advanced Lithotripter Technology on SWL Success: Insights from Modulith SLK Inline Outcomes

ERDOĞAN¹,

ŞİMŞEK¹,

AŞIK

et al. 2024

Preprint

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This study aims to evaluate the success rate of Shock Wave Lithotripsy (SWL) in treating kidney stones using the Modulith SLK Inline lithotripter, with a focus on the importance of device efficacy as emphasized in EAU guidelines. Patients and methods: This retrospective single-center study includes 208 patients who underwent SWL treatment for kidney stones between June 2023 and June 2024. Treatment outcomes were collected and analyzed in detail, considering patients' demographic characteristics (age, gender) and stone parameters (size, location, and hardness [Hounsfield Unit, HU]). The success of SWL was defined as achieving complete stone clearance or the presence of clinically insignificant residual fragments (CIRF) (< 4 mm). This sample of 208 patients was specifically selected to evaluate the performance of the Modulith SLK Inline lithotripter in treating stones smaller than 15 mm, aiming to examine SWL’s potential as a non-invasive yet effective treatment option for smaller, more manageable stones. This study seeks to provide detailed insights into the optimal use cases of SWL. Results: The mean age of the 208 patients was 42.2 ± 12.7 years (18–75), with a male-to-female ratio of 1.9:1. The overall success rate of SWL was 78.8%, with 164 patients achieving a complete stone-free status. With the inclusion of the cases with CIRF the overall success rate was assessed as 92.3%. While the mean stone size in successful cases was 10.3 mm, this value was 12.5 mm, in cases with residual fragments or treatment failure. A statistically significant relationship was found between stone size and treatment success rates (p < 0.001). The mean Hounsfield Unit (HU) value for all patients was 874.0 ± 283.2, with significantly lower HU values in patients who achieved a completely stone-free status (p = 0.049). Stone localization did not significantly affect the success rates after SWL (p = 0.377). Conclusions: SWL has demonstrated its effectiveness in kidney stone treatment with a 78.8% complete stone-free rate using the Modulith SLK Inline lithotripter. Higher success rates were achieved with smaller stones (< 15 mm) and lower HU values. These findings support the significance of advanced lithotripter technology in establishing SWL as a valuable non-invasive option for stones under 15 mm.

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Extracorporeal Shock Wave Lithotripsy in Management of Urolithiasis

Cited by 3 publications

References 6 publications

Prospective Evaluation of Extracorporeal Shockwave Lithotripsy in Renal and Upper Ureteric Stone Treatment: Clinical Assessment and Results

Prospective Evaluation of Extracorporeal Shockwave Lithotripsy in Renal and Upper Ureteric Stone Treatment: Clinical Assessment and Results

Outcome of extracorporeal shock wave lithotripsy for renal and upper ureteric stone clearance

Impact of Advanced Lithotripter Technology on SWL Success: Insights from Modulith SLK Inline Outcomes

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