1
|
Wagenius M, Oddason K, Utter M, Popiolek M, Forsvall A, Lundström KJ, Linder A. Factors influencing stone-free rate of Extracorporeal Shock Wave Lithotripsy (ESWL); a cohort study. Scand J Urol 2022; 56:237-243. [DOI: 10.1080/21681805.2022.2055137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Magnus Wagenius
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
- Department of Urology Helsingborg Hospital, Helsingborg, Sweden
| | - Karl Oddason
- Department of Urology Helsingborg Hospital, Helsingborg, Sweden
| | - Maria Utter
- Department of Urology Helsingborg Hospital, Helsingborg, Sweden
| | - Marcin Popiolek
- Department or Urology, Örebro University Hospital, Örebro, Sweden
| | - Andreas Forsvall
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
- Department of Urology Helsingborg Hospital, Helsingborg, Sweden
| | - Karl-Johan Lundström
- Institution of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Adam Linder
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
| |
Collapse
|
2
|
Daly KM, Chaker K, Rhouma SB, Chehida MAB, Ouanes Y, Sellami A, Nouira Y. [Evaluation of protocols on the use of analgesics for pain management in patients with extracorporeal shock wave lithotripsy (ESWL)]. Pan Afr Med J 2019; 32:109. [PMID: 31223399 PMCID: PMC6560981 DOI: 10.11604/pamj.2019.32.109.17690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 01/27/2019] [Indexed: 11/11/2022] Open
Abstract
La douleur ressentie au cours d'une séance de lithotritie extracorporelle (LEC) est le facteur limitant le plus important de cette technique. Le but de notre travail était de comparer l'efficacité des différents types d'analgésiques utilisés pour le contrôle de la douleur pendant les séances de LEC. Nous avons mené une étude prospective colligeant 300 patients présentant une lithiase urinaire justifiant un traitement par LEC. Les patients ont été répartis de façon randomisée en trois groupes: le groupe I, incluant 100 patients ayant reçu 2cc de sérum physiologique en IM (intra musculaire) (placebo), le groupe II regroupant 100 patients ayant reçu 100mg de kétoprofène en IM tandis que le groupe III colligeant 100 patients ayant eu une application locale d'une crème contenant la lidocaïne et la prilocaïne. L'échelle visuelle analogique (EVA) a servi à évaluer la douleur à 10 minutes et à la fin de la séance. L'EVA moyenne à 10 minutes et à la fin de la LEC étaient respectivement de 3,7 et 4,91. Aucune différence significative n'a été trouvée entre les trois groupes concernant: les données épidémiologiques (âge, sexe, IMC, antécédents pathologies) et les caractéristiques du calcul (côté, taille, localisation, présence ou non de sonde double J). L'interruption précoce de la séance de LEC a été notée chez 11 patients du groupe I, avec une différence significative par rapport aux autres groupes (p=0,003). L'EVA à 10 minutes et à la fin de séance de LEC, était statistiquement plus élevée dans le groupe I par rapport aux groupes II et III (p < 0,001). Aussi, la LEC était nettement plus efficace dans les groupes (II et III) comparativement au groupe I (p<0,001). L'utilisation d'un traitement antalgique est nécessaire lors de la séance de lithotritie extracorporelle. Les deux molécules antalgiques évaluées ont montré un bon contrôle de la douleur ainsi qu'une augmentation de l'efficacité du traitement par lithotritie.
Collapse
Affiliation(s)
- Kheireddine Mrad Daly
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Kays Chaker
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Sami Ben Rhouma
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Mohamed Ali Ben Chehida
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Yassine Ouanes
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Ahmed Sellami
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| | - Yassine Nouira
- Service d'Urologie, Hôpital La Rabta, Faculté de Médecine de Tunis, Université de Tunis, El Manar, Tunisie
| |
Collapse
|
3
|
Hashem A, Ghobrial FK, Elbaset MA, Atwa AM, Fadallah M, Laymon M, El-Assmy A, Sheir KZ, Abol-Enein H. Efficacy of pethidine, ketorolac, and lidocaine gel as analgesics for pain control in shockwave lithotripsy: A single-blinded randomized controlled trial. Investig Clin Urol 2019; 60:251-257. [PMID: 31294134 PMCID: PMC6607066 DOI: 10.4111/icu.2019.60.4.251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 04/07/2019] [Indexed: 11/26/2022] Open
Abstract
Purpose To compare the safety and efficacy of xylocaine gel and ketorolac as opioid-sparing analgesia compared with pethidine for shock wave lithotripsy (SWL) pain. Materials and Methods A single-blinded randomized controlled trial (RCT) was performed in 132 patients with renal and upper ureteral stones amenable to treatment with SWL. The first patient group received intravenous (IV) pethidine and placebo gel; the second group received IV ketorolac plus placebo gel; the third group received lidocaine gel locally plus normal saline IV. Stone disintegration was classified as none (no change from basal by kidney, ureter, bladder X-ray or ultrasound [US] imaging), partial (fragmented and >4-mm residual fragments), and complete (≤4-mm residual fragments). Stone disintegration was assessed by kidney-ureter-bladder X-ray and US imaging. Pain was evaluated by use of the Numeric Pain Rating Scale (NPRS). Results The NPRS scores were highest in the xylocaine group at 10, 20, and 30 minutes (p=0.0001) with no significant difference between the ketorolac and pethidine groups, except at 10 minutes (p=0.03) and a near significant difference at 30 minutes (p=0.054) in favor of ketorolac. Results for stone disintegration (none, partial, and complete, respectively) were as follows: 25 (50.0%), 23 (46.0%), and 2 (4.0%) for pethidine; 19 (35.8%), 23 (43.4%), and 11 (20.8%) for ketorolac; and 26 (89.7%), 3 (10.3%), and 0 (0.0%) for lidocaine (p=0.008). Conclusions Ketorolac is a safe and more effective alternative to morphine derivatives for SWL analgesia. Lidocaine gel should not be used as mono-analgesia for SWL.
Collapse
Affiliation(s)
- Abdelwahab Hashem
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Fady K Ghobrial
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - M A Elbaset
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed M Atwa
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mohamed Fadallah
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mahmoud Laymon
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed El-Assmy
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Khaled Z Sheir
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Hassan Abol-Enein
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| |
Collapse
|
4
|
Pricop C, Radavoi G, Puia D, Vechiu C, Jinga V. OBESITY: A DELICATE ISSUE CHOOSING THE ESWL TREATMENT FOR PATIENTS WITH KIDNEY AND URETERAL STONES? ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2019; -5:133-138. [PMID: 31149074 PMCID: PMC6535322 DOI: 10.4183/aeb.2019.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT Urolithiasis and obesity are now public health problems with an increased incidence worldwide. Management of urolithiasis in patients with morbid obesity is usually associated with higher morbidity and mortality compared to non-obese patients. ESWL is a nonsurgical procedure for the treatment of lithiasis. In obese patients the ESWL efficacy is influenced by the skin-to-stone distance or poorer detection of the calculus because of the fatty tissue. OBJECTIVE To highlight the overweight or obese lithiasic patient profile that could be best treated by ESWL. SUBJECTS AND METHODS We evaluated ESWL results in 1393 patients with kidney or ureteral stones between 5 and 20 mm. They were divided into 4 groups according to the BMI: Group A-overweight (BMI=25-30 kg/m2); Group B-grade I obesity (BMI=30-35 kg/m2); Group C-grade II obesity (BMI=35-40 kg/m2) and a control group of normal weight (BMI=18-25 kg/m2). RESULTS Patients with a higher BMI required a greater number of ESWL sessions. A statistically significant greater number of patients with a waist circumference of >102 cm required more than 2 SWL sessions (p=0.007). Location of the stones in the pelvic ureter had the highest rate of success for obese patients (p=0.00001). The ESWL success rate in overweight and obese patients can be negatively influenced by BMI, abdominal circumference over 102 cm, and hardness of calculi reflected in the radiopacity on KUB. CONCLUSIONS In patients with grade II obesity, pyelocaliceal calculus and increased hardness, other urological alternatives to lithiasis should be considered from the beginning.
Collapse
Affiliation(s)
- C. Pricop
- “Gr.T.Popa” University of Medicine and Pharmacy - Urology, Iasi, Romania
- “Dr. C.I. Parhon” Hospital - Department of Urology and Renal Transplantation, Iasi, Romania
| | - G.D. Radavoi
- “Prof. Dr. Th. Burghele” Clinical Hospital - Urology, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - D. Puia
- “Gr.T.Popa” University of Medicine and Pharmacy - Urology, Iasi, Romania
- “Dr. C.I. Parhon” Hospital - Department of Urology and Renal Transplantation, Iasi, Romania
| | - C. Vechiu
- “Dr. C.I. Parhon” Hospital - Department of Urology and Renal Transplantation, Iasi, Romania
| | - V. Jinga
- “Prof. Dr. Th. Burghele” Clinical Hospital - Urology, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
5
|
Ichiyanagi O, Nagaoka A, Izumi T, Kawamura Y, Kato T. Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy. Urolithiasis 2015; 43:419-26. [PMID: 25981235 DOI: 10.1007/s00240-015-0783-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/06/2015] [Indexed: 11/27/2022]
Abstract
We investigated the effects of aging on the stone-free rate (SFR) after shock wave lithotripsy (SWL) for the treatment of proximal ureteral calculi. A total of 247 consecutive patients were retrospectively selected, classified into seven groups set at 10 year increments (from 20 to 90 years), and examined for SFR after SWL. According to our final analysis, 185 male and 62 female patients with an average age of 54.1 years had stones with a diameter of 11.5 mm and a density of 893.1 Hounsfield units. On average, SFR was 74.9 % at 3 months after 1.7 SWL sessions. SFR gradually reached ≥ 90 % for each age-group after 1.5-2 years. Median durations to achieve 50 % SFR were estimated to be 21 and 86 days for those in their 20 and 80 s, respectively. However, the difference between the two estimates was not significant (p = 0.064). The durations to achieve 50 % SFR for the other groups lay between these two estimates. Aging does not affect long-term SFR, but patients aged ≥ 80 years might experience delayed stone clearance within the first 12 months after SWL.
Collapse
Affiliation(s)
- Osamu Ichiyanagi
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata City, Yamagata Prefecture, Japan.
| | - Akira Nagaoka
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata City, Yamagata Prefecture, Japan
| | - Takuji Izumi
- Department of Urology, South Miyagi Medical Center, Aza-nishi 38-1, Ogawara Town, Miyagi Prefecture, Japan
| | - Yuko Kawamura
- Department of Urology, South Miyagi Medical Center, Aza-nishi 38-1, Ogawara Town, Miyagi Prefecture, Japan
| | - Tomoyuki Kato
- Department of Urology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, Yamagata City, Yamagata Prefecture, Japan
| |
Collapse
|
6
|
Demir A, Cecen K, Karadag MA, Uslu M, Arslan OE. Pain control using pethidine in combination with diazepam compared to diclofenac in combination with hyoscine-n-butyl bromide: in patients undergoing extracorporeal shock wave lithotripsy. Cent European J Urol 2015; 68:201-6. [PMID: 26251744 PMCID: PMC4526601 DOI: 10.5173/ceju.2015.479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 10/07/2014] [Accepted: 01/02/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction Extracorporeal Shock Wave Lithotripsy (ESWL) remains the preferred least invasive treatment for urinary tract stones. The main purpose of this study was to compare two treatment modalities for pain control during the ESWL procedure. Material and methods From 2013 to 2014, 220 patients received ESWL for kidney stones. Before the procedure, the weight and height were measured to determine the body mass index (BMI); in addition, oxygen saturation and the pulse of the patients, as well as pain level were determined. The pain control provided included two different methods: diclofenac sodium plus hyoscine-N-butyl bromide in the first group and pethidine plus diazepam in the second group. The pain level of the patients was determined using two different scales: the Wong-Baker and the Visual Analogue scales (VAS). At the end of three sessions, all patients were evaluated for the stone fragmentation rate by plain abdominal X-ray, and the findings were recorded and analyzed. Results A total of 220 patients were enrolled in this study. There were 91 patients in the first group (diclofenac sodium + hyoscine-N-butyl bromide) (male/female: 63/28) and 129 (male/female: 83/46) patients in the second group (pethidine HCL +diazepam). The mean age with SD according to each group was 42.03 (±16.43) and 42.56 (±14.23), respectively (p = 0.8). With regard to pain scores (using the Wong-Baker and VAS scales), the responses were significantly lower in the second group (p <0.001). Conclusions Pethidine in combination with diazepam was superior to diclofenac and Hyoscine-N-butyl bromide for pain in patients undergoing ESWL.
Collapse
Affiliation(s)
- Aslan Demir
- Kafkas University, Medical School, Department of Urology, Kars, Turkey
| | - Kursat Cecen
- Kafkas University, Medical School, Department of Urology, Kars, Turkey
| | - Mert Ali Karadag
- Kafkas University, Medical School, Department of Urology, Kars, Turkey
| | - Mehmet Uslu
- Kafkas University, Medical School, Department of Urology, Kars, Turkey
| | - Omer Erkam Arslan
- Kafkas University, Medical School, Department of Urology, Kars, Turkey
| |
Collapse
|
7
|
Carpentier X, Meria P, Bensalah K, Chabannes E, Estrade V, Denis E, Yonneau L, Mozer P, Hadjadj H, Hoznek A, Traxer O. Mise au point sur la prise en charge des calculs du rein en 2013. Comité Lithiase de l’Association française d’urologie. Prog Urol 2014; 24:319-26. [DOI: 10.1016/j.purol.2013.09.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 01/29/2023]
|
8
|
Cui Y, Cao W, Shen H, Xie J, Adams TS, Zhang Y, Shao Q. Comparison of ESWL and ureteroscopic holmium laser lithotripsy in management of ureteral stones. PLoS One 2014; 9:e87634. [PMID: 24498344 PMCID: PMC3912003 DOI: 10.1371/journal.pone.0087634] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 12/29/2013] [Indexed: 11/18/2022] Open
Abstract
Background There are many options for urologists to treat ureteral stones that range from 8 mm to 15 mm, including ESWL and ureteroscopic holmium laser lithotripsy. While both ESWL and ureteroscopy are effective and minimally invasive procedures, there is still controversy over which one is more suitable for ureteral stones. Objective To perform a retrospective study to compare the efficiency, safety and complications using ESWL vs. ureteroscopic holmium laser lithotripsy in management of ureteral stones. Methods Between October 2010 and October 2012, 160 patients who underwent ESWL or ureteroscopic holmium laser lithotripsy at Suzhou municipal hospital for a single radiopaque ureteral stone (the size 8–15 mm) were evaluated. All patients were followed up with ultrasonography for six months. Stone clearance rate, costs and complications were compared. Results Similarity in stone clearance rate and treatment time between the two procedures; overall procedural time, analgesia requirement and total cost were significantly different. Renal colic and gross hematuria were more frequent with ESWL while voiding symptoms were more frequent with ureteroscopy. Both procedures used for ureteral stones ranging from 8 to 15 mm were safe and minimally invasive. Conclusion ESWL remains first line therapy for proximal ureteral stones while ureteroscopic holmium laser lithotripsy costs more. To determining which one is preferable depends on not only stone characteristics but also patient acceptance and cost-effectiveness ratio.
Collapse
Affiliation(s)
- Yon Cui
- Department of Urology, Suzhou Municipal Hospital, Suzhou, China
| | - Wenzhou Cao
- Department of Urology, Suzhou Municipal Hospital, Suzhou, China
| | - Hua Shen
- Department of Urology, Suzhou Municipal Hospital, Suzhou, China
| | - Jianjun Xie
- Department of Urology, Suzhou Municipal Hospital, Suzhou, China
| | - Tamara S. Adams
- Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States of America
| | - Qiang Shao
- Department of Urology, Suzhou Municipal Hospital, Suzhou, China
- * E-mail:
| |
Collapse
|
9
|
Al-Marhoon MS, Shareef O, Al-Habsi IS, Al Balushi AS, Mathew J, Venkiteswaran KP. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital. Oman Med J 2013; 28:255-9. [PMID: 23904918 DOI: 10.5001/omj.2013.72] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 06/05/2013] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones. METHODS Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. RESULTS Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85%) had renal stones and 33 (15%) had ureteric stones. The mean±SD stone size was 11.3±4.5 mm, while the mean age of the patients was 39.9±12.8 years with 68.5% males. The mean renal stone size was 11.6±4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9±3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones) was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5%) with renal stones and 13 patients (39.4%) with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones). Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004) and the number of shockwaves (p=0.021). CONCLUSION Siemens Modularis Vario lithotripter is a safe and effective tool for treating renal and ureteric stones.
Collapse
Affiliation(s)
- Mohammed S Al-Marhoon
- Urology Division, Department of Surgery, Sultan Qaboos University Hospital, Sultanate of Oman
| | | | | | | | | | | |
Collapse
|
10
|
Shock wave lithotripsy versus ureteroscopy for ureteral calculi: a prospective assessment of patient-reported outcomes. World J Urol 2012; 31:1569-74. [DOI: 10.1007/s00345-012-0966-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022] Open
|
11
|
Clinical experience with shock-wave lithotripsy using the Siemens Modularis Vario lithotripter. Arab J Urol 2011; 9:101-5. [PMID: 26579276 PMCID: PMC4150585 DOI: 10.1016/j.aju.2011.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 02/20/2011] [Accepted: 02/27/2011] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To assess the effectiveness of a lithotripter (Modularis Vario; Siemens, AG Healthcare, Munich, Germany) in the management of renal and ureteric stones. PATIENTS AND METHODS In all, 1146 adult patients with renal or ureteric stones were treated at one urological centre using the latest model of the Modularis Vario lithotripter. The effectiveness of lithotripsy and re-treatment rate were assessed. Data were obtained on stone location, stone size, shock wave usage, success rate, and complications. RESULTS Between May 2007 and November 2009, 698 patients with renal stones and 448 with ureteric stones underwent extracorporeal shock-wave lithotripsy (ESWL). The mean (SD) renal stone size was 12.8 (3.8) mm; a mean of 1.36 sessions was required, with a mean (SD) number of 3744 (1961) shocks delivered per renal stone. After 3 months, the success rate defined as the patient being stone-free or with residual fragments of <4 mm; for renal stones the rate was 91.1%, with a 6.9% complication rate in the form of steinstrasse and severe renal colic. The mean (SD) ureteric stone size was 10.4 (2.7) mm. A mean of 1.37 sessions was required, with a mean (SD) of 4551 (2467) shocks delivered for each ureteric stone. The success rate for ureteric stones was 89.5%, with a 5.6% complication rate. The overall efficiency quotient was 0.66. CONCLUSION The Siemens Modularis Vario lithotripter is a safe and effective machine for treating renal and ureteric stones.
Collapse
|