SWL literature
SWL Literature

Abdelbary AM. et al., 2021: Value of early second session shock wave lithotripsy in treatment of upper ureteric stones compared to laser ureteroscopy

Abdelbary AM, Al-Dessoukey AA, Moussa AS, Elmarakbi AA, Ragheb AM, Sayed O, Elbatanouny AM, Latif AAE, Lofty AM, Mohamed AG, Salah S, Ibrahim RM.
Department of Urology, Faculty of Medicine, Beni-Suef University, Beni-seuf, 62511, Egypt.
Department of Urology, Beni-Suef Insurance Hospital, Beni-seuf, Egypt.
Department of Urology, Faculty of Medicine, Beni-Suef University, Beni-seuf, 62511, Egypt.

Abstract

Purpose: The safety and efficacy of early second session shock wave lithotripsy (SWL) compared with laser ureteroscopy (URS) for the treatment of upper ureteric stones were evaluated.

Methods: From January to October 2019, 108 patients with upper ureteric stones (< 1.5 cm and ≤ 1000 Hounsfield unit (HU)) were randomized into SWL and laser URS groups. The second SWL session was performed within 48-72 h of the first session. Using plain abdominal X-ray and ultrasonography, patients were evaluated 48-72 h after the first SWL session and one week after the second and third SWL sessions or one week after URS. The procedure was considered a success when no additional procedures were needed to clear the stone. To determine the stone-free rate (SFR), noncontrast computed tomography of the urinary tract was performed three months postoperatively.

Results: In the SWL group, the success rates were 92.6% and 94.4% after the second and third sessions. The SFR was 96.2% in the laser URS group. The success rates were not significantly different between the second and third SWL sessions versus the laser URS (p = 0.418 and 0.660, respectively). Operative and fluoroscopy times were significantly longer in the SWL group (p = 0.001), and JJ stent insertions were needed after laser URS.

Conclusion: Ultraslow full-power SWL treatment of patients with upper ureteric stones (< 1.5 cm and ≤ 1000 HU) with an early second session is safe and effective compared to laser URS. Patients who do not respond to early second SWL session should be shifted to another treatment modality.

World J Urol. 2021 Jan 20. doi: 10.1007/s00345-020-03560-x. Online ahead of print. PMID: 33471164

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Comments 1

Peter Alken on Wednesday, July 07 2021 08:30

This is the third publication on ultraslow SWL treatment (1,2) and the second publication of the Egyptian group (1). The results are impressive and extremely good especially if other groups will be able to duplicate the results.

1 Al-Dessoukey AA, et al. Ultraslow full-power shock wave lithotripsy versus slow power-ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study. Int J Urol. 2020 Feb;27(2):165-170. doi: 10.1111/iju.14158
2 Ito K, et al. Extremely-slow, half-number shockwave lithotripsy for asymptomatic renal stones

This is the third publication on ultraslow SWL treatment (1,2) and the second publication of the Egyptian group (1). The results are impressive and extremely good especially if other groups will be able to duplicate the results. 1 Al-Dessoukey AA, et al. Ultraslow full-power shock wave lithotripsy versus slow power-ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study. Int J Urol. 2020 Feb;27(2):165-170. doi: 10.1111/iju.14158 2 Ito K, et al. Extremely-slow, half-number shockwave lithotripsy for asymptomatic renal stones
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Sunday, November 28 2021

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