Value of early second session shock wave lithotripsy in treatment of upper ureteric stones compared to laser ureteroscopy

Abdelbary, Ahmed; Al‐Dessoukey, Ahmad A; Moussa, Ayman S.; Elmarakbi, Akram A; Ragheb, Ahmed M.; Sayed, Osama; Elbatanouny, Ahmed M; Latif, Muhammad M. M. Abdel; Lofty, Amr M; Mohamed, Ahmed Osman; Salah, Shehab; Ibrahim, Rabie M

doi:10.1007/s00345-020-03560-x

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…Hence, in the era of COVID-19, the use of SWL in the treatment of UUTS has been outweighed by urologists in our center, especially after the development of new SWL protocols, providing nearly the same stone-free rate (SFR) and complications as compared to laser ureteroscopy (URS). [ 4 ] Moreover, SWL is available, noninvasive, and of lower cost, which favors its use during a pandemic, although improving its SFR and safety are still mandatory. [ 5 ] This study aimed to evaluate factors that can improve SWL results to keep up with COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Shock wave lithotripsy in the era of COVID-19

Ibrahim,

Elzawy,

Ragheb

et al. 2024

Urology Annals

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Objective: The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic. Methods: Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m2 were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40–50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1st 300 shocks. Success rate and complications were recorded. Results: Five hundred and ninety patients completed the study. The success rate after 1st session was 408/590 patients (69.15%) which was augmented by 2nd session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2). Conclusions: SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic.

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Section: Introductionmentioning

confidence: 99%

Shock wave lithotripsy in the era of COVID-19

Ibrahim,

Elzawy,

Ragheb

et al. 2024

Urology Annals

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“…Salem et al [ 11 ] reported that the SFR was comparable between SWL and semirigid URS, while the mean costs were significantly higher in the SWL group; however, critical confounding factors, such as BMI, Hounsfield units of the stone, and hydronephrosis, were not adjusted in the study; Zhang et al [ 14 ] found that the SFR following SWL was equivalent to semirigid ureteroscopy based on subgroup analysis, while SWL had a significant advantage with respect to the complication rate, charges, and period of hospitalization compared with the URS group. In another RCT, Ahmed et al [ 15 ] reported that SWL is safe and effective compared to flexible URS; however, compared with the electrohydraulic lithotripter they used, the best results in stone fragmentation and fewer analgesia requirements occurred with the electromagnetic lithotripter [ 16 ]. The previous studies concerning this issue were limited and had a small number of participants.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Zhan

et al. 2023

World J Urol

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Purpose To compare the effectiveness, safety, and cost between ultrasound-guided shock wave lithotripsy (SWL) with an early second session protocol and ureteroscopy (URS) in patients with proximal ureteral stones using the propensity score matching (PSM) method based on a large prospective study. Methods This prospective study was conducted in a tertiary hospital from June 2020 to April 2022. Patients who underwent lithotripsy (SWL or URS) for proximal ureteral stones were enrolled. The stone-free rate (SFR), complications, and cost were recorded. PSM analysis was performed. Results A total of 1230 patients were included, of whom 81.1% (998) were treated with SWL and 18.9% (232) were treated with URS. After PSM, the SWL group had an equivalent SFR at one month (88.7 vs. 83.6%, P = 0.114) compared with the URS group. Complications were rare and comparable between the two groups, while the incidence of ureteral injuries was higher in the URS group compared with the SWL group (1.4 vs. 0%, P = 0.011). The hospital stay was significantly shorter (1 day vs. 2 days, P < 0.001), and the cost was considerably less (2000 vs. 25,053, P < 0.001) in the SWL group compared with the URS group. Conclusion This prospective PSM cohort demonstrated that ultrasound-guided SWL with an early second session protocol had equivalent effectiveness but better safety and lower cost compared with URS in the treatment of patients with proximal ureteral stones, whether the stones were radiopaque or radiolucent. These results will facilitate treatment decisions for proximal ureteral stones. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-023-04307-0.

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Prospective comparison of extracorporeal shock wave lithotripsy and ureteroscopy in distal ureteral stones

Gong

Zhang

et al. 2023

Urolithiasis

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Value of early second session shock wave lithotripsy in treatment of upper ureteric stones compared to laser ureteroscopy

Cited by 7 publications

References 15 publications

Shock wave lithotripsy in the era of COVID-19

Shock wave lithotripsy in the era of COVID-19

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

Prospective comparison of extracorporeal shock wave lithotripsy and ureteroscopy in distal ureteral stones

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