SWL literature
SWL Literature

Kaygisiz O. et al., 2021: Which frequency is better for pediatric shock wave lithotripsy? Intermediate or low: a prospective randomized study.

Kaygisiz O, Cicek MC, Mert A, Akesen S, Sarandol E, Kilicarslan H.
Department of Urology, Faculty of Medicine, Bursa Uludag University, Nilufer, Bursa, Turkey.
Department of Urology, Faculty of Medicine, Bursa Uludag University, Nilufer, Bursa, Turkey.
Urology Clinic, Serik State Hospital, Turkish Ministry of Health, Serik, Antalya, Turkey.
Department of Anesthesiology, Faculty of Medicine, Bursa Uludag University, Nilufer, Bursa, Turkey.
Department of Biochemistry, Faculty of Medicine, Bursa Uludag University, Nilufer, Bursa, Turkey.

Abstract

Purpose: Shock wave lithotripsy (SWL) is the first option in the treatment of pediatric kidney stones; however, optimal frequency is still uncertain. The aim of this study was to compare low frequency [60 shocks per minute (SWs/min)] and intermediate frequency [90 SWs/min] in terms of lithotripsy success, complications, cardiac arrhythmia, anesthesia time, secondary procedures, and efficiency quotient (EQ) in children.

Methods: Seventy-eight consecutive children who received SWL for radiopaque renal stones between July 2016 and January 2020 were randomly divided into two groups: Group 60 (SWL frequency: 60 SWs/min) and Group 90 (SWL frequency: 90 SWs/min). After exclusion (remaining 71 children), Group 60 (n = 38) and Group 90 (n = 33) were compared using univariate analysis.

Results: The median age of children (37 girls, 34 boys) was 5 (1-16) years. Patient demographics and stone features were similar between the groups. Success rate after the last SWL session was 81.6% (n = 31) for Group 60 and 87.9% (n = 29) for Group 90 (p = 0.527). Stone-free rate after the first, second, and third sessions was 42.1%, 18.4%, and 21.1% for Group 60 and 48.5%, 27.3%, and 12.1% for Group 90, respectively. Additional treatment rate was similar between the groups. In Group 60, the EQ was 57.83, and it was 64.07 in Group 90. Median total anesthesia time was significantly longer in Group 60 (74.5 min) than in Group 90 (32 min; p < 0.001).

Conclusion: Intermediate frequency and low-frequency pediatric SWL have similar success rates; however, intermediate-frequency SWL has a shorter anesthesia time.
World J Urol. 2021 Apr 22. doi: 10.1007/s00345-021-03696-4. Online ahead of print. PMID: 33890144.

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Commentaires 1

Hans-Göran Tiselius le mardi 19 octobre 2021 08:30

The authors compared in an RCT the importance of the frequency of shockwave generation on stone-free rates in children. Treatments were given with low (60 sw/min) and intermediate (90 sw/min). All treatments were carried out with the Turkish lithotripter Elmed.
No significant difference was recorded, but the stone-free rate after one session was slightly lower than I expected. Based on the reported data I would personally choose frequency 90. It needs to be mentioned, however, that no information is available on possible negative tissue effects caused by the higher sw-frequency.

Hans-Göran Tiselius

The authors compared in an RCT the importance of the frequency of shockwave generation on stone-free rates in children. Treatments were given with low (60 sw/min) and intermediate (90 sw/min). All treatments were carried out with the Turkish lithotripter Elmed. No significant difference was recorded, but the stone-free rate after one session was slightly lower than I expected. Based on the reported data I would personally choose frequency 90. It needs to be mentioned, however, that no information is available on possible negative tissue effects caused by the higher sw-frequency. Hans-Göran Tiselius
Invité
dimanche 28 novembre 2021

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