Peter Alken, MD
Professor of Urology
Department of Urology, Universitätsklinik Mannheim
Ruprecht- Karls-Universität Heidelberg
68135 Mannheim, Germany

Stoykov B. et al., 2020: Low-intensity extracorporeal shockwave therapy in the treatment of erectile dysfunction after penile trauma

Stoykov B, Kolev N, Dunev V, Genov P.
Department of Urology, Medical University Pleven, Bulgaria.
Department of Urology, UMHAT, Ruse, Bulgaria.

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Peter Alken
“To confirm the results, a longer-term study involving more patients is needed.” This will probably not happen.... Read More
Monday, May 25 2020 08:30
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Kallidonis P. et al., 2020: Systematic Review and Meta-analysis Comparing Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery and Shock Wave Lithotripsy for Lower Pole Renal Stones

Kallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T, Skolarikos A, Tailly T.
Department of Urology, University of Patras, Patras, Greece.
European Section of Uro-Technology.
Young Academic Urologist.
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Department of Urology, Fundacion Puigvert, University Autonoma of Barcelona, Barcelona, Spain.
Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany.
2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Urology, Ghent University Hospital, Ghent, Belgium.

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Peter Alken
Systematic reviews are needed from time to time to reliably capture and describe the current situation. But the most interesting ... Read More
Wednesday, May 20 2020 08:30
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Hegazy M. et al., 2020: The alternating bidirectional versus the standard approach during shock wave lithotripsy for upper lumbar ureteric stones: a randomized controlled trial

Hegazy M, El-Assmy A, Ali-El-Dein B, Sheir KZ.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

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Peter Alken
Clever idea, well done study, impressive difference of results except the low SFR in both groups compared to old data like the ~ 8... Read More
Monday, May 18 2020 08:15
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El-Khoury HJ. et al., 2019: Impact of modern media on analgesic requirements during extracorporeal shockwave lithotripsy

El-Khoury HJ, Brookes JDL, Tan B, Shahbaz S, McCahy PJ.
Department of Urology, Casey Hospital, Monash Health, Melbourne, Victoria, Australia.
School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.

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Peter Alken
All patients got the standard medication: ”Our standard pre-treatment analgesia of a non-steroidal anti-inflammatory drug supposit... Read More
Monday, April 27 2020 08:30
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Torricelli FCM. et al, 2019: Renal Stone Features Are More Important Than Renal Anatomy to Predict Shock Wave Lithotripsy Outcomes: Results from a Prospective Study with CT Follow-Up

Abstract

Introduction: Lower pole kidney stones have been associated with poor shock wave lithotripsy (SWL) outcomes because of its location. However, the real impact of collecting system anatomy on stone clearance after SWL is uncertain. There is a lack of prospective well-controlled studies to determine whether lower pole kidney stones have inferior outcomes than nonlower pole kidney stones when treated with SWL. Methods: We prospectively evaluated patients with a single kidney stone of 5-15 mm undergoing SWL from June 12 through January 19. All patients were subjected to computed tomography before and 3 months after the procedure. Demographic data (age, gender, and body mass index), stone features (stone size, stone area, stone density, and stone-skin distance-SSD), and collecting system anatomy (infundibular length and width, and infundibulopelvic angle) were recorded. Outcomes (fragmentation and stone clearance rates) were compared between lower pole and nonlower pole cases. Then, a multivariate analysis including all variables was performed to determinate which parameters significantly impact on SWL outcomes. Results: One hundred and twenty patients were included in the study. Mean stone size was 8.3 mm and mean stone density was 805 Hounsfield units. Overall stone fragmentation, success, and stone-free rates were 84.1%, 64.1%, and 34.1%, respectively. There were no significant differences in stone fragmentation (76.0% vs 71.4%; p = 0.624), success rate (57.6% vs 53.3%; p = 0.435), and stone-free rate (40.2% vs 35.7%; p = 0.422) in the lower vs nonlower pole groups, respectively. On multivariate analysis, only stone density (p < 0.001) and SSD (p = 0.006) significantly influenced fragmentation. Stone size (p = 0.029), stone density (p = 0.002), and SSD (p = 0.049) significantly influenced kidney stone clearance. Conclusions: Stone size, stone density, and SSD impact on SWL outcomes. Lower pole kidney stones have similar fragmentation and stone clearance compared with nonlower pole kidney stones.
J Endourol. 2020 Jan;34(1):63-67. doi: 10.1089/end.2019.0545. Epub 2019 Nov 21.

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Peter Alken
Good study with a result against common believe. The authors classified two different positive results: Stone-free: absence of ... Read More
Thursday, April 23 2020 08:30
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Cui HW. et al., 2019: Predicting shockwave lithotripsy outcome for urolithiasis using clinical and stone computed tomography texture analysis variables

Cui HW, Silva MD, Mills AW, North BV, Turney BW.
Oxford Stone Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
University of Lisbon, Faculty of Sciences, Lisbon, Portugal.
Exploristics Ltd., Belfast, United Kingdom.
Oxford Stone Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.

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Peter Alken
Another very good study in the last quarter of 2019: It’s so good to read the results of a well done study and well written paper ... Read More
Friday, April 17 2020 08:30
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Han CS et al., 2019: Dual-frequency setting for urinary stone fragmentation during shock wave lithotripsy: an in vitro study

Han CS, Vetter JM, Endicott R, Chevinsky M, Zafar A, Venkatesh R.
Washington University School of Medicine, St. Louis, MO, USA.
Midwest Stone Institute, St. Louis, MO, USA.
Washington University School of Medicine, St. Louis, MO, USA.

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Recent Comments
Othmar Wess
The study is one of several other studies confirming the strategy of slow (60 shocks per min) vs. fast (120 shocks per min) shock ... Read More
Wednesday, April 08 2020 07:45
Peter Alken
I wonder how the authors developed the hypothesis evaluated in the experiments. I find the theory formulated by them not very conc... Read More
Wednesday, April 08 2020 06:52
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Gulati G. et al., 2019: Massive retroperitoneal hemorrhage after external shock wave lithotripsy in a patient with a left ventricular assist device

Gulati G, Kiernan M, Sabe MA.
Cardiovascular Center, Tufts Medical Center, Boston, MA, United States.
Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

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Peter Alken
“As many as 10% of patients suffer pump thrombosis, even with optimal anticoagulation management”. “In LVAD patients undergoing no... Read More
Thursday, April 02 2020 08:30
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Yadav P. et al., 2019: Technique, complications, and outcomes of pediatric urolithiasis management at a tertiary care hospital: evolving paradigms over the last 15 years

Yadav P, Madhavan K, Syal S, Farooq A, Srivastava A, Ansari MS.
Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, U.P., 226014, India.
Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, U.P., 226014, India.

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Peter Alken
This is a well done extensive metaanalysis on pediatric urolithiasis management. It is also an example of the typical puzzling wa... Read More
Friday, March 27 2020 08:25
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Lee SM. et al., 2019: Optimisation of shock wave lithotripsy: a systematic review of technical aspects to improve outcomes

Lee SM, Collin N, Wiseman H, Philip J.
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Department of Interventional Radiology, Southmead Hospital, Bristol, UK.

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Peter Alken
It is somehow refreshing to read the different technical details of shock wave lithotripsy optimization in a systematic review inc... Read More
Monday, March 23 2020 08:25
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Sir E. et al., 2019: The analgesic efficacy of ultrasound guided unilateral transversus abdominis plane block in the pain management of shock wave lithotripsy (Abstract only)

Sir E, Eksert S, Zor M, Emin Ince M, Kaya E, Bedir S.
Servicio de Anestesiología. Hospital de Investigación y Formación Gulhane. Ankara Turkey.
Servicio de Urología. Hospital de Investigación y Formación Gulhane. Ankara Turkey.

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Hiller SC. et al., 2020: Frontiers of stone management

Hiller SC, Ghani KR.
Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

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Peter Alken
This is a short, well written overview on the current frontiers of all minimal invasive stone therapy techniques. I recommend read... Read More
Thursday, March 12 2020 08:30
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Kim KS. et al., 2019: Electromagnetic Low-Intensity Extracorporeal Shock Wave Therapy in Patients with Erectile Dysfunction: A Sham-Controlled, Double-Blind, Randomized Prospective Study

Kim KS, Jeong HC, Choi SW, Choi YS, Cho HJ, Ha US, Hong SH, Lee JY, Lee SW, Ahn ST, Moon DG, Bae WJ, Kim SW.
Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

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Peter Alken
Hmm!? Good conclusion. It is common to present data in a way that they make a good impression The Erection Hardness Score (EHS) (... Read More
Friday, March 06 2020 08:35
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Kim KS. et al., 2019: Electromagnetic Low-Intensity Extracorporeal Shock Wave Therapy in Patients with Erectile Dysfunction: A Sham-Controlled, Double-Blind, Randomized Prospective Study

Kim KS, Jeong HC, Choi SW, Choi YS, Cho HJ, Ha US, Hong SH, Lee JY, Lee SW, Ahn ST, Moon DG, Bae WJ, Kim SW.
Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

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Peter Alken
Hmm!? Good conclusion. It is common to present data in a way that they make a good impression The Erection Hardness Score (EHS) (... Read More
Friday, March 06 2020 08:30
525 Hits
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Liu Y. et al., 2019: Colonic hematoma after extracorporeal shock wave lithotripsy for pancreatic stones: a case report

Liu Y, Hao L, Wang T, Li ZS, Xu ZL, Hu LH.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, 1017 North Dongmen Road, Shenzhen, Guangdong, China.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.

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Peter Alken
The first case report of a colonic hematoma after EWSL for pancreatic stones. What I find more astonishing are the postprocedural... Read More
Monday, February 24 2020 08:30
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Sramkova T. et al., 2019: Erectile Dysfunction Treatment Using Focused Linear Low-Intensity Extracorporeal Shockwaves: Single-Blind, Sham-Controlled, Randomized Clinical Trial

Sramkova T, Motil I, Jarkovsky J, Sramkova K.
Department of Sexology, University Hospital and Department of Traumatology, Masaryk University, Brno, Czechia.
Department of Urology First Faculty of Medicine, Charles University Prague and General University Hospital, Prague, Czechia.
EURED Urology, Andrology Center, Brno, Czechia.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia.
Department of Urology, St. Anna Hospital, Brno, Czechia.

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Peter Alken
Reading this paper I had from the very start - even before getting to the methods section - the feeling that it will surely show... Read More
Tuesday, February 18 2020 08:30
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Dauw CA. et al., 2019: Shockwave Lithotripsy Use in the State of Michigan: American Urological Association Guideline Adherence and Clinical Implications

Dauw CA, Swarna K, Qi J, Kim T, Leavitt D, Leese J, Abdelhady M, Witzke K, Hollingsworth JM, Ghani KR.
University of Michigan, Ann Arbor, MI.
University of Michigan, Ann Arbor, MI.
Henry Ford Health System-Vattikuti Urology Institute, Detroit, MI.
IHA-Urology, Ypsilanti, MI.
Detroit Medical Center-Department of Urology, Detroit, MI.
MidMichigan-Division of Urology, Midland, MI.

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Peter Alken
The authors evaluated adherence to the following guideline recommendations: 1 Guideline: “Routine antibiotic prophylaxis is not re... Read More
Friday, February 14 2020 08:30
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Bowen DK. et al., 2019: Retreatment after Ureteroscopy and Shockwave Lithotripsy: A Population-Based Comparative Effectiveness Study

Bowen DK, Song L, Faerber J, Kim J, Scales CD Jr, Tasian GE.
Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Duke Clinical Research Institute, Departments of Surgery (Urology) and Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Department of Surgery, Division of Urology; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

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Peter Alken
This is the kind of important publication that turns the focus of clinical reports away from the typical “we have done so many cas... Read More
Wednesday, February 12 2020 08:30
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Sohail N. et al., 2019: Is There Any Improvement In Efficacy Of Xtracorporeal Shockwave Lithotripsy Therapy For Treating Renal Stones With Invent Of New Shockwave Machines?

Sohail N, Albodour A, Abdelrahman KM.
Alkhor Hospital, Hamad Medical Corporation, Doha, Qatar.

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Peter Alken
The results are good but there is no serious argument in the publication if and why the results are really better than what we kno... Read More
Friday, January 31 2020 08:15
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Gokce Mİ. et al., 2019: The role of a novel decision aid to support informed decision making process in patients with a symptomatic non - lower pole renal stone

Gokce Mİ, Akpınar C, Esen B, Solak V, Gülpınar O, Bedük Y.
Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
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Peter Alken
The patient chooses the therapeutic procedure. To be able to do so, he must be well informed and understand his diagnosis, the the... Read More
Tuesday, January 28 2020 08:15
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Jeong HC. et al., 2019: Synergistic effects of extracorporeal shockwave therapy and modified Ojayeonjonghwan on erectile dysfunction in an animal model of diabetes

Jeong HC, Bae WJ, Zhu GQ, Jeon SH, Choi SW, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang SY, Kim SW.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
KEMIMEDI, Seoul, Korea.

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Peter Alken
The herbal formula - KH-204 - used in the experiments is a watery extract of 5 different plants which is also commercially avail... Read More
Friday, January 17 2020 08:15
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Donaldson JF. et al., 2019: Treatment of Bladder Stones in Adults and Children: A Systematic Review and Meta-analysis on Behalf of the European Association of Urology Urolithiasis Guideline Panel

Donaldson JF, Ruhayel Y, Skolarikos A, MacLennan S, Yuan Y, Shepherd R, Thomas K, Seitz C, Petrik A, Türk C, Neisius A.
Department of Urology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Department of Urology, Skåne University Hospital, Malmö, Sweden.
Second Department of Urology, Sismanoglio Hospital, Athens Medical School, Athens, Greece.
Academic Urology Unit, University of Aberdeen, Scotland, UK.
Division of Gastroenterology & Cochrane UGPD Group, Department of Medicine, Health Sciences Centre, McMaster University, Hamilton, Canada.
European Association of Urology Guidelines Office, Arnhem, The Netherlands.
Department of Urology, Guy's Hospital, London, UK.
Department of Urology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria.
Department of Urology, Charles University, First Faculty of Medicine, Prague, Czech Republic.
Department of Urology, Hospital of the Sisters of Charity, Vienna, Austria; Urologische Praxis mit Steinzentrum, Vienna, Austria.
Department of Urology, Hospital of the Brothers of Mercy Trier, Johannes Gutenberg University Mainz, Trier, Germany.

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Peter Alken
I do not agree with the first sentence of this review: “Despite constituting only approximately 5% of all urinary tract stones, bl... Read More
Friday, January 10 2020 08:15
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Marchetti KA. et al., 2019: Extracorporeal shock wave lithotripsy versus ureteroscopy for management of pediatric nephrolithiasis in upper urinary tract stones: multi-institutional outcomes of efficacy and morbidity

Marchetti KA, Lee T, Raja N, Corona L, Kraft KH, Wan J, Ellison JS.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
University of Michigan Medical School, Ann Arbor, MI, USA.
Division of Pediatric Urology, Department of Urology, University of Michigan, Ann Arbor, MI, USA.
5Division of Pediatric Urology, Children's Hospital of Wisconsin & Medical College of Wisconsin, Milwaukee, WI, USA.

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Peter Alken
Publications on stone treatment often focus on the narrow part of urological action from diagnosis to treatment and neglect other ... Read More
Monday, January 06 2020 08:00
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Jeon SH. et al., 2019: Extracorporeal shock wave therapy decreases COX-2 by inhibiting TLR4-NFκB pathway in a prostatitis rat model

Jeon SH, Zhu GQ, Kwon EB, Lee KW, Cho HJ, Ha US, Hong SH, Lee JY, Bae WJ, Kim SW.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Republic of Korea.

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Peter Alken
Shock waves exhibit a surprising variety of positive effects in different situations like e.g. in the treatment of the chronic pro... Read More
Wednesday, December 25 2019 08:15
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Spivak L. et al., 2019: Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction in Diabetic Patients

Spivak L, Shultz T, Appel B, Verze P, Yagudaev D, Vinarov A.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Electronic address: .
Medispec Ltd., Gaithersburg, Maryland, USA.
Neuro-urology Unit, Rambam Healthcare Campus, Haifa, Israel.
Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

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Peter Alken
The conclusion is simple and straight forward: ”LI-ESWT is safe and effective for the treatment of ED in PDE5I-R and PDE5I-NR grou... Read More
Friday, December 20 2019 08:15
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Yamashita S. et al., 2019: Ureteral wall volume at ureteral stone site is a critical predictor for shock wave lithotripsy outcomes: comparison with ureteral wall thickness and area

Yamashita S, Kohjimoto Y, Iguchi T, Nishizawa S, Kikkawa K, Hara I.
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan.
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan.

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Peter Alken
The 49, 3 % success rate of the present series is inexplicably low. In 2015 Sarica K et al. (1) did a very similar study on ESWL t... Read More
Wednesday, December 11 2019 08:15
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Pietropaolo A. et al., 2019: Endourological management (PCNL, URS, SWL) of stones in solitary kidney - A systematic review from European Association of Urologists (EAU) Young Academic Urologists (YAU) and Uro-Technology (ESUT) groups

Pietropaolo A, Reeves T, Aboumarzouk O, Kallidonis P, Ozsoy M, Skolarikos A, Tailly T, Liatsikos E, Traxer O, Somani BK.
Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.
Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Medical University of Vienna, Vienna, Austria.
2nd Department of Urology, University of Athens, Sismanoglio Hospital, Athens, Greece.
Department of Urology, University Hospitals Ghent, Ghent, Belgium.
Tenon Hospital, Pierre and Marie Curie University, Paris, France.

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Peter Alken
“With no recommended guidelines on the management of stones in solitary kidney, our aim was to conduct a systematic review of lite... Read More
Thursday, December 05 2019 08:15
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Yayik AM. et al., 2019: Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study

Yayik AM, Ahiskalioglu A, Alici HA, Celik EC, Cesur S, Ahiskalioglu EO, Demirdogen SO, Karaca O, Adanur S.
Department of Anesthesiology, Regional Training and Research Hospital, Erzurum, Turkey.
Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Urology, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Anesthesiology and Reanimation, Baskent University, Konya, Turkey.

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Peter Alken
The patients in the treatment arm were not asked how much they were bothered by the QLB procedure and there was no control group w... Read More
Tuesday, December 03 2019 08:15
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Betschart P. et al., 2019: Spoilt for Choice: A Survey of Current Practices of Surgical Urinary Stone Treatment and Adherence to Evidence-Based Guidelines among Swiss Urologists

Betschart P, Zumstein V, Jichlinski P, Herrmann TRW, Knoll T, Engeler DS, Müllhaupt G, Schmid HP, Abt D.
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Urology, University Hospital of Lausanne, Lausanne, Switzerland.
Department of Urology, Cantonal Hospital Thurgau, Thurgau, Switzerland.
Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany.

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Peter Alken
SWL is also in retreat in Switzerland. 40% of the participants of this survey had no own SWL device and only 55% of them referred... Read More
Friday, November 29 2019 08:15
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El-Tatawy H. et al., 2019: Management of 'forgotten' encrusted JJ stents using extracorporeal shockwave lithotripsy: A single-centre experience

El-Tatawy H, El-Abd AS, Gameel TA, Ramadan AR, Abo Farha MO, Sabaa MA, El-Abd SA.
Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.

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Peter Alken
This is the largest series of forgotten stents I am aware of.
Wednesday, January 22 2020 08:15
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Sultan S. et al., 2019: Update on Surgical Management of Pediatric Urolithiasis.

Sultan S, Aba Umer S, Ahmed B, Naqvi SAA, Rizvi SAH.
Philip G. Ransley Department of Paediatric Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

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Peter Alken
Pediatric urolithiasis is more frequent in countries like Pakistan than in western countries. This is a very good up-to-date revie... Read More
Tuesday, December 31 2019 08:15
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Zeng T. et al., 2019: Effect of mechanical percussion combined with patient position change on the elimination of upper urinary stones/fragments: a systematic review and meta-analysis

Zeng T, Tiselius HG, Huang J, Deng T, Zeng G, Wu W.
Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China.
Division of Urology, Department of Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.

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Peter Alken
We have to learn new abbreviations: “Mechanical percussion combined with patient position change (MPPP) includes two intervention ... Read More
Wednesday, November 20 2019 08:28
1376 Hits
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Krieger JR. et al., 2019: Shockwave Therapy in the Treatment of Peyronie's Disease

Krieger JR, Rizk PJ, Kohn TP, Pastuszak A.
Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Urology, University of Miami, Miami, FL, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.

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Peter Alken
Yes!
Friday, November 15 2019 08:17
1595 Hits
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Elbaset MA. et al., 2019: Optimal non-invasive treatment of 1-2.5 cm radiolucent renal stones: oral dissolution therapy, shock wave lithotripsy or combined treatment-a randomized controlled trial

Elbaset MA, Hashem A, Eraky A, Badawy MA, El-Assmy A, Sheir KZ, Shokeir AA.
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Urology Department, Mediclin Muritz Hospital, Waren, Germany.
Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

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Peter Alken
This is an important paper because ODT is frequently neglected (because ESWL, PNL or URS get a much better reimbursement than pres... Read More
Monday, November 11 2019 09:11
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Dai JC. et al., 2019: Innovations in Ultrasound Technology in the Management of Kidney Stones

Dai JC, Bailey MR, Sorensen MD, Harper JD. Department of Urology, University of Washington School of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356510, Seattle. Center for Industrial and Medical Ultrasound, University of Washington, 1014 NorthEast 40th Street, Seattle, WA 98105, USA; Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195, USA. Puget Sound Veterans Affairs Hospital, 1660 S. Columbian Way, Seattle, WA 98108, USA.

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Peter Alken
A good review for those not yet familiar with sonography.
Friday, November 01 2019 09:06
1428 Hits
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Alexander CE. et al., 2019: Impact of Case Volume on Shock Wave Lithotripsy Outcomes: Data from the National Shock Wave Lithotripsy Database of New Zealand

Alexander CE, Gowland S, Cadwallader J, Hopkins D, Reynard JM, Turney BW.
School of Medicine, University of St Andrews, St Andrews, United Kingdom.
Mobile Medical Technology, Christchurch, New Zealand.
Mobile Medical Technology, Auckland, New Zealand.
Oxford Stone Group, Department of Urology, Nuffield Department of Surgical Sciences, The Churchill Hospital, Oxford, United Kingdom.

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Peter Alken
It is difficult to comment this statistic based paper. First and single treatment stone cases over a 20-year study period were ev... Read More
Monday, October 28 2019 08:57
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Rayegani SM. et al., 2019: Extracorporeal Shockwave Therapy Combined with Drug Therapy in Chronic Pelvic Pain Syndrome - A Randomized Clinical Trial

Rayegani SM, Razzaghi MR, Raeissadat SA, Allameh F, Eliaspour D, Abedi AR, Javadi A, Rahavian AH.
Physical Medicine and Rehabilitation Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Laser Application in Medical Sciences Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Center of Excellence in Training Laser Application in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Physical Medicine and Rehabilitation Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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Peter Alken
The body of literature on CP/CPPS is ever increasing but the efficacy of the diagnostic and therapeutic armamentarium is not. In t... Read More
Wednesday, October 23 2019 08:46
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Maxwell AD. et al., 2019: Evaluation of Renal Stone Comminution and Injury by Burst Wave Lithotripsy in a Pig Model

Maxwell AD, Wang YN, Kreider W, Cunitz BW, Starr F, Lee D, Nazari Y, Williams JC Jr, Bailey MR, Sorensen MD. Department of Urology, University of Washington School of Medicine, Seattle, Washington. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington.
Department of Radiology, University of Washington School of Medicine, Seattle, Washington.
Department of Anatomy and Cell Biology, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana.
Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington.

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Peter Alken
GREAT!
Friday, October 18 2019 08:36
1787 Hits
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Yuan P. et al., 2019: Efficacy of low-intensity extracorporeal shock wave therapy for the treatment of chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta-analysis

Yuan P, Ma D, Zhang Y, Gao X, Liu Z, Li R, Wang T, Wang S, Liu J, Liu X.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

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Peter Alken
There is no “one for all” therapy to treat CP/CPPS. ESWT will only help a certain subset of patients. The advantage is the lack o... Read More
Monday, October 14 2019 08:36
1660 Hits
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Eryilmaz R. et al., 2019: Comparison of focused and unfocused ESWT in treatment of erectile dysfunction

Eryilmaz R, Kaplan Ş, Aslan R, Demir M, Taken K.
Department of Urology , Yuzuncu Yil University, School of Medicine , Van , Turkey. Department of Urology , Van Educational Research Hospital , Van , Turkey.

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Peter Alken
“Erectile dysfunction (ED) is one of the most common disorders in male” I am always surprised to see that urologists have succeede... Read More
Tuesday, July 23 2019 09:26
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Talso M. et al., 2019: ESWL state of the art

Talso M, Tefik T, Mantica G, Rodriguez Socarras M, Kartalas Goumas I, Somani BK, Esperto F.
Department of Urology, ASST Vimercate Hospital, Monza Brianza, Italy.
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy. Department of Urology, ASST Vimercate Hospital, Monza Brianza, Italy. Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK. Department of Urology, Humanitas Gavezzeni, Bergamo, Italy.

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Peter Alken
This is a well done review on very individual historical details of ESWL and its current application. It is a surprise to see that... Read More
Wednesday, October 09 2019 09:21
1723 Hits
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Chi-Fai N. et al., 2019: Effect of stepwise voltage escalation on treatment outcomes following extracorporeal shockwave lithotripsy of renal calculi: a prospective randomized study

Chi-Fai N, Yee CH, Teoh JY, Lau B, Leung SC, Wong CY, Tak WK, Chu WC, Yuen J.
SH Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong , Hong Kong.
Department of Imaging and Intervention Radiology, The Chinese University of Hong Kong , Hong Kong.
School of Nursing, Hong Kong Polytechnic University , Hong Kong.

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Peter Alken
A very well designed and performed study that deserves reading! A few noteworthy details are: “The thickness of haematoma for ramp... Read More
Thursday, September 26 2019 09:07
1770 Hits
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Irer B. et al., 2019: Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones. Aegean Study Group of the Society of Urological Surgery

Irer B, Sahin MO, Erbatu O, Yildiz A, Ongun S, Cinar O, Cihan A, Sahin M, Sen V, Ucer O, Kizilay F, Bozkurt O.
Departments of Urology, Izmir Metropolitan Municipality Esrefpasa Hospital, Izmir, Turkey, Manisa State Hospital, Manisa, Celal Bayar University School of Medicine, Manisa, Dokuz Eylul University School of Medicine, Izmir, Balikesir University School of Medicine, Balıkesir, Bulent Ecevit University School of Medicine, Zonguldak, Nigde Omer Halisdemir University School of Medicine, Nigde,Department of Urology, Ege University School of Medicine, Izmir, Manisa State Hospital, Manisa, Turkey.

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Peter Alken
The authors quote 4 other studies on the same topic (1-4) of which three simple case–control studies (1,3,4) with similar results... Read More
Monday, September 30 2019 09:10
1464 Hits
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Pricop C. et al., 2019: OBESITY: A DELICATE ISSUE CHOOSING THE ESWL TREATMENT FOR PATIENTS WITH KIDNEY AND URETERAL STONES?

Pricop C, Radavoi GD, Puia D, Vechiu C, Jinga V
Gr.T.Popa" University of Medicine and Pharmacy - Urology, Iasi, Romania.
"Dr. C.I. Parhon" Hospital - Department of Urology and Renal Transplantation, Iasi, Romania.
"Prof. Dr. Th. Burghele" Clinical Hospital - Urology, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

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Peter Alken
Best results were achieved in patients with pelvic stones. Unfortunately the authors do not communicate in which position the pelv... Read More
Friday, September 20 2019 09:02
1660 Hits
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Yazici O. et al., 2019: Effect of JJ stent on outcomes of extracorporeal shock wave lithotripsy treatment of moderate sized renal pelvic stones: A randomized prospective study

Yazici O, Kafkasli A, Erbin A, Bilal Hamarat M, Cubuk A, Sarilar O, Sarica K.
Department of Urology, Haseki Training and Research Hospital, Estambul, Turquía. Department of Urology, Kucukyali Delta Hospital, Estambul, Turquía. Department of Urology, Konya Training and Research Hospital, Iconio, Turquía.

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Peter Alken
Currently no comment available.
Monday, September 16 2019 08:58
1442 Hits
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Nazarov TK. et al., 2019: [Role of biomarkers of acute kidney damage during lithotripsy of high-density stones] (original article only in Russian)

Nazarov TK, Komyakov BK, Rychkov IV, Trubnikova KE, Tursunov AI.
FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia.

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Peter Alken
Currently no comment available.
Wednesday, September 11 2019 08:49
1481 Hits
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Sugiyama M. et al., 2019: Repeated spontaneous migration of ureteral stent in hemiplegia patient during ureteral stone treatment

Sugiyama M, Fujimura M, Nakamori H, Nishikawa R, Sakamoto S, Sekita N, Suzuki H, Mikami K, Ichikawa T.
Department of Urology, Chibaken Saiseikai Narashino Hospital
Department of Urology, Chiba University, 1-8-1, Inohana, Japan
Department of Urology, Funabashi Central Hospital, Japan.
Department of Urology, Toho University Medical Center Sakura Hospital, Japan.

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Peter Alken
Currently no comment available.
Thursday, September 05 2019 08:28
1626 Hits
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Khanna A. et al., 2019: Ureteral Stent Placement during Shockwave Lithotripsy: Characterizing Guideline Discordant Practice

Khanna A, Monga M, Sun D, Gao T, Schold J, Abouassaly R. Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH.
Quantitative Health Science, Cleveland Clinic, Cleveland, OH.

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Peter Alken
Guidelines published in 1997 (1), 2007 (2) and 2016 (3) discouraged the use of stents together with ESWL because of lack of outcom... Read More
Thursday, August 29 2019 08:30
1706 Hits
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Özsoy M. et al., 2019: Sex differences in the therapy of kidney and ureteral stones

Özsoy M, Somani B, Seitz C, Veser J, Kallidonis P.
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital.
Urology and Andrology, Karl Landsteiner Society, Vienna, Austria.
University Hospital Southampton NHS Trust.
University of Southampton, Southampton, UK.
Department of Urology, University of Patras, Patras, Greece

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Peter Alken
This is an interesting collection of references on male/female differences but also an easy mixture of casual and causal relations... Read More
Friday, August 23 2019 08:34
1673 Hits
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Scotland K. et al., 2019: Total Surface Area Influences Stone Free Outcomes in Extracorporeal Shock Wave Lithotripsy for Distal Ureteral Calculi

Scotland K, Safaee Ardekani G, Chan J, Paterson R, Chew BH.

Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

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Peter Alken
It is nice to read that ESWL is regarded and proved to be an excellent and unjustly forgotten treatment modality. The abstract som... Read More
Monday, August 19 2019 08:26
1517 Hits
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Kaydu A. et al., 2019: Frequency of anxiety and depression in patients of urtolithiasis undergoing Extracorporeal Shock Wave Lithotripsy in Diyarbakir, Turkey

Kaydu A, Gokcek E.
Department of Anesthesiology, Diyarbakir State Hospital, Diyarbakir, Turkey.

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Peter Alken
The first sentence is another typical confusion of causal and casual relations: “Extracorporeal shock wave lithotripsy (ESWL) can ... Read More
Wednesday, August 14 2019 08:20
1677 Hits
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Ichiyanagi O. et al., 2019: Reinforcement of the Triple D score with simple addition of the intrarenal location for the prediction of the stone-free rate after shockwave lithotripsy for renal stones 10-20 mm in diameter

Ichiyanagi O, Fukuhara H, Kurokawa M, Izumi T, Suzuki H, Naito S, Nishida H, Kato T, Tsuchiya N.
Department of Urology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata, 998-9585, Japan. Department of Urology, Yamagata Prefectural Kahoku Hospital, 111 Aza-Gassando, Yachi, Kahoku, 999-3511, Department of Urology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata, 998-9585, Japan.
Department of Urology, Nihonkai General Hospital, 30 Akiho-cho, Sakata, 998-8501, Japan.
Department of Urology, South Miyagi Medical Center, 38-1 Aza-nishi, Ogawara, Miyagi, 989-1253, Japan.
Department of Urology, Yamagata City Hospital Saiseikan, 1-3-26 Nanoka-mahi, Yamagata, 990-8533, Japan.

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Peter Alken
The Triple D score - composed of SSD, stone density, and stone volume - was introduced in 2015 (1) and was revalidated and conf... Read More
Friday, August 09 2019 09:12
2136 Hits
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Kirshenbaum EJ. et al., 2019: Socioeconomic Disparities in the Acute Management of Stone Disease in the United States

Kirshenbaum EJ, Doshi C, Dornbier R, Blackwell RH, Bajic P, Gupta GN, Gorbonos A, Turk TMT, Flanigan RC, Baldea KG
Loyola University Medical Center, Department of Urology, Maywood, Illinois.
Southern Illinois University School of Medicine, Division of Urology, Springfield, Illinois

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Peter Alken
Papers from the USA on health policy and systems research have the unique advantage to get access to the data of very large number... Read More
Monday, August 05 2019 09:04
1626 Hits
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Chung KJ. et al., 2019: Changing Trends in the Treatment of Nephrolithiasis in the Real World

Chung KJ, Kim JH, Min GE, Park HK, Li S, Del Giudice F, Han DH, Chung BI.
Department of Urology, Stanford University Medical Center, Stanford, California.
Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea. Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

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Peter Alken
8 Urologists from Korea, Italy and the USA contributed to this paper and the way they discuss the different procedures and circums... Read More
Wednesday, July 31 2019 08:55
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Hassanpour N. et al., 2019: Study on Radiation Dose Received by Patients during Extracorporeal Shock Wave Lithotripsy

Hassanpour N, Panahi F, Naserpour F, Karami V, Fatahi Asl J, Gholami M. A
Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Radiology Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Medical Physics, Lorestan University of Medical Sciences, Khorramabad, Iran.

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Peter Alken
The oblique position may be chosen in case obese patients have to be treated with a short focal depth machine. I remember the revi... Read More
Friday, July 26 2019 08:49
1872 Hits
1 Comment

Sokolakis I. et al., 2019: Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials

Sokolakis I, Hatzichristodoulou G.
Department of Urology and Paediatric Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany.

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Peter Alken
A positive aspect of this meta-analysis is the detailed analysis of the drawbacks of previous meta-analyses; this is a prerequisit... Read More
Monday, July 22 2019 08:37
2042 Hits
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Liu T. et al., 2019: Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy

Liu T, Shindel AW, Lin G, Lue TF.
Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, 94143, USA.
Department of Urology, Beijing Shijitan Hospital, Capital Medical University, 100038, Beijing, China.

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  1835 Hits
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Peter Alken
This is an extensive overview on the action of shock waves on soft tissue. Treatment of ED is just one aspect and basic research i... Read More
Wednesday, July 17 2019 08:29
1835 Hits
1 Comment

Nomikos M. et al., 2019: Retroperitoneal Abscess Formation Extending to the Lumbar Area After Extracorporeal Shock Wave Lithotripsy

Nomikos M, Tsalavoutas A, Kalpaxi A, Athanasopoulos G.
Department of Urology, Thriassion General Hospital, Athens, Greece.
Department of Radiology, Thriassion General Hospital, Athens, Greece.

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Peter Alken
What could have been done different? A look at the CT-images at admission and 4 days later showed that the 7 Fr. Double-J stent di... Read More
Friday, July 12 2019 09:14
1883 Hits
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González-Pombo M et al., 2019: M, Márquez-Rivas J. Extracorporeal Shockwave Lithotripsy Procedure in Children With Intrathecal Baclofen Pump

González-Pombo M, Márquez-Rivas J.
Neurosurgery Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Neuroscience Applied Group, Instituto de Biomedicina de Sevilla, Sevilla, Spain.

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Peter Alken
3 similar published cases of stone treatment in patients with intrathecal drug delivery devices are collected by the authors. Medt... Read More
Friday, July 12 2019 08:07
2004 Hits
1 Comment

Assaf E. et al., 2019: Perinephric Hematoma with Active Arterial Hemorrhage following Extracorporeal Shockwave Lithotripsy

Assaf E, Abou Zahr R, Ghabi E, Ghantous I.
Urology Department, St George Hospital University Medical Center, University of Balamand, Beirut, Lebanon.
Faculty of Medicine and Medical Sciences, St George Hospital University Medical Center, University of Balamand, Beirut, Lebanon.

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  2132 Hits
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Recent comment in this post
Peter Alken
Currently no comment available.
Wednesday, July 03 2019 09:00
2132 Hits
1 Comment

Hevia M. et al., 2019: [Design and validation of a satisfaction questionnaire in patients with urolithiasis treated by extracorporeal shock wave lithotripsy (ESWL).] (Original Article only in Spanish)

Hevia M, Robles JE, Chiva S, Doménech P, García Á, Ancizu FJ, Velis JM, Díez-Caballero F, Rosell D, Guillén F, Pascual JI.
Departamento de Urología. Clínica Universidad de Navarra. Pamplona. España.
Unidad de Medicina Preventiva. Clínica Universidad de Navarra. Pamplona.

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  2034 Hits
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Recent comment in this post
Peter Alken
Currently no comment available.
Friday, June 28 2019 08:53
2034 Hits
1 Comment

Sokolakis I. et al., 2019: The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies

Sokolakis I, Dimitriadis F, Teo P, Hatzichristodoulou G, Hatzichristou D, Giuliano F.
Department of Urology and Paediatric Urology, Julius Maximilian University Medical Centre of Würzburg, Würzburg, Germany; Centre for Sexual and Reproductive Health, Aristotle University of Thessaloniki, Greece;  Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Department of Global Clinical Research, Dornier MedTech Asia Pte Ltd, Singapore. Poincare Hospital AP-HP, Garches, UMR1179 Inserm-UVSQ-Paris Saclay University, Paris, France.

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  2214 Hits
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Recent comment in this post
Peter Alken
The first quarter of 2019 offers at least 7 publication on LI-ESWT (1-7) The LI-ESWT community seems to stand up like one man to ... Read More
Monday, June 24 2019 08:31
2214 Hits
1 Comment

Patel P. et al., 2019: Should Low-intensity Extracorporeal Shockwave Therapy Be the First-line Erectile Dysfunction Treatment for Nonresponders to Phosphodiesterase Type 5 Inhibition?

Patel P, Fode M, Lue T, Ramasamy R.
Department of Urology, University of Miami, Miami, FL, USA.
Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Urology, University of California, San Francisco, San Francisco, CA, USA.

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  2180 Hits
  1 Comment
Recent comment in this post
Peter Alken
The first quarter of 2019 offers at least 7 publication on LI-ESWT (1-7) The LI-ESWT community seems to stand up like one man to ... Read More
Friday, June 21 2019 08:21
2180 Hits
1 Comment

Choudhary A. et al., 2019: A novel triple oral regime provides effective analgesia during extracorporeal shockwave lithotripsy for renal stones

Choudhary A, Basu S, Sharma R, Gupta R, Das RK, Dey RK.
Department of Urology, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.
Department of Urology, Apex Hospital, Jaipur, Rajasthan, India.

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Peter Alken
“Fragmentation was classified into complete ( 4-mm fragments), partial (4-mm fragments), and no fragmentation.” “Success was defin... Read More
Wednesday, June 19 2019 09:00
2388 Hits
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Shirvani M. et al., 2019: Unilateral endogenous Candida endophthalmitis after extracorporeal shock wave lithotripsy for a renal stone in an immunocompetent woman: a case report

Shirvani M, Hosseini S, Maalhagh M, Afarid M, Mirza-Khanlooi A, Mohaghegh S.
Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz University of Medical Sciences, Shiraz, Iran.

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  2215 Hits
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Recent comment in this post
Peter Alken
This is an extremely rare complication. Of five cases reported in the literature in 2006, 2015 and 3 in 2017, 4 had a proven funga... Read More
Thursday, June 13 2019 08:54
2215 Hits
1 Comment

Alathel AH. et al., 2019: The New/Novel Oral Anticoagulants and Their Impact on Patients Being Considered for Shock Wave Lithotripsy: The Findings of an International Survey of the Endourological Society

Alathel AH, Nott L, Bjazevic J, Chew BH, Pace KT, Razvi H.
Division of Urology, Department of Surgery, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Division of Urology, Department of Surgery, Western University, London, Canada.
Department of Urological Sciences, University of British Columbia, Vancouver, Canada.
Division of Urology, Department of Surgery, University of Toronto, Toronto, Canada.

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Recent comment in this post
Peter Alken
“Unfortunately, the literature related to SWL and the risks of bleeding associated with antiplatelet/anticoagulants in general has... Read More
Thursday, June 06 2019 08:47
2832 Hits
1 Comment

Alken P. et al., 2019: [Looking back on 50 years of stone treatment] (Original Article only in German)

Alken P., Knoll T.
Klinikum Sindelfingen-Böblingen, Urologische Klinik Sindelfingen, Sindelfingen.
Universitätsmedizin Mannheim, Klinik für Urologie, Mannheim.

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  2850 Hits
  1 Comment
Recent comment in this post
Peter Alken
Currently no comment available.
Tuesday, June 04 2019 08:39
2850 Hits
1 Comment

Liu R. et al., 2019: Quantitative factors of unenhanced CT for predicting fragmenting efficacy of extracorporeal shock wave lithotripsy on pancreatic duct stones

Liu R, Su W, Wang J, Gong J, Lu J.
Department of Radiology,Department of Nuclear Medicine, Changhai Hospital Affiliated to the Second Military Medical University, Changhai Road 168, Yangpu District, Shanghai, 200433 PR China.

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  2709 Hits
  1 Comment
Recent comment in this post
Peter Alken
The ease with which Gastroenterologists treat pancreatic duct stones with several ESWL sessions always impressed me. At the same ... Read More
Friday, May 31 2019 08:30
2709 Hits
1 Comment

Li X et al., 2018: Outcomes of long-term follow-up of asymptomatic renal stones and prediction of stone-related events

Li X, Zhu W, Lam W, Yue Y, Duan H, Zeng G.
Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Division of Urology, Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China. Department of Urology, Longgang Central Hospital, Shenzhen, China.

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Peter Alken
Currently no comment available.
Wednesday, May 29 2019 08:41
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Turan T et al., 2018: Can intervals in extracorporeal shock wave lithotripsy sessions affect success in the treatment of upper ureteral stones?

Turan T, Efioglu O, Danacioglu YO, Sendogan F, Culpan M, Gunaydin B, Atis RG, Caskurlu T, Yildirim A.
Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.

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Peter Alken
An often desired answer to a neglected question is given in this small study. All patients had received a 2-week conservative trea... Read More
Monday, May 27 2019 08:37
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Hao L et al., 2018: Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis

Hao L, Liu Y, Wang T, Guo HL, Wang D, Bi YW, Xin L, He L, Lin JH, Zhang D, Zeng XP, Zou WB, Chen H, Xie T, Li BR, Cong ZJ, Wang LS, Liao Z, Xu ZL, Li ZS, Hu LH.
Department of Gastroenterology, Hainan Branch of Chinese PLA General Hospital, Sanya, China.  Gongli Hospital, The Second Military Medical University, Shanghai, China. Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China. Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China. Air Force General Hospital, Beijing, China. Department of General Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Shenzhen, China.

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Peter Alken
The long term outcome is evaluated in a matched pair analysis of 72 geriatric group patients with 72 of 1322 patients from the con... Read More
Friday, May 24 2019 08:30
2803 Hits
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Xun Y et al., 2018: Single extracorporeal shock-wave lithotripsy for proximal ureter stones: Can CT texture analysis technique help predict the therapeutic effect?

Xun Y, Li J, Geng Y, Liu Z, Yu X, Wang X, Xiao F, Li Z, Li C, Wang S.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.

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Peter Alken
CT texture analysis has been most frequently applied to image processing of malignant tumors. There are also a few publications de... Read More
Monday, May 20 2019 08:15
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Yamashita S, et al., 2018: Three-dimensional mean stone density measurement is superior for predicting extracorporeal shock wave lithotripsy success

Yamashita S, Kohjimoto Y, Iwahashi Y, Iguchi T, Iba A, Nishizawa S, Hara I.
Department of Urology, Wakayama Medical University, Wakayama, Japan.

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Peter Alken
On first glance it makes more sense to measure the mean density (MSD) of a whole stone to determine the stone’s susceptibility to ... Read More
Friday, May 17 2019 08:15
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Haraldsson S et al., 2018: Extracorporeal shock wave lithotripsy for pancreatic duct stones: an observational study

Haraldsson S, Roug S, Nøjgaard C, Novovic S, Gluud LL, Feldager E, Schmidt PN.
Department of Gastroenterology, Landspitali - University Hospital, Reykjavik, Iceland. Abdominal Center K, Bispebjerg Hospital, Copenhagen, Denmark. Department of Gastroenterology and Gastrointestinal Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.

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Peter Alken
The results remember me of the fact that ESWL frequently improved the pain situation of patients with medullary sponge kidneys des... Read More
Wednesday, May 15 2019 08:40
2748 Hits
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Islamoglu E et al., 2018: Does extracorporeal shock wave lithotripsy-related pain get affected by menstrual cycle and menopause?

Islamoglu E, Tas S, Karamik K, Yalcinkaya S, Tokgoz H, Savas M
University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.

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Peter Alken
This is a well done gender study on female pain perception during ESWL written by five males. “… as far as we know our study is t... Read More
Monday, May 13 2019 08:31
2760 Hits
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Bianchi G. et al., 2018: Comparison of an electromagnetic and an electrohydraulic lithotripter: Efficacy, pain and complications

Bianchi G, Marega D, Knez R, Bucci S, Trombetta C.
Department of Urology, University of Trieste, Cattinara Hospital, Trieste.

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Peter Alken
Sometimes better results are achieved with new machine and sometimes with thorough instructions in the proper use of machines. I r... Read More
Thursday, May 09 2019 08:25
2862 Hits
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Liu Y et al., 2018: Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones: A case report

Department of Gastroenterology, Gongli Hospital.Changhai Hospital, The Second Military Medical University, Shanghai.
Hainan Branch of Chinese PLA General Hospital, Sanya.
Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai.
Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, Guangdong, China

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Peter Alken
Currently no comment available.
Monday, May 06 2019 08:20
2844 Hits
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Tao RZ et al., 2018: External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy: a prospective randomized trial

Tang QL, Zhou S, Jia CP, Lv JL.

Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.

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Peter Alken
This is the 4th publication on the the EPVL (Friend I) (1-3). The device consists of two essential pieces: a mechanical oscillator... Read More
Friday, May 03 2019 10:43
2727 Hits
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Reynolds LF et al., 2018: Indications and contraindications for shock wave lithotripsy and how to improve outcomes

Kroczak T, Pace KT.
Division of Urology, St. Michael's Hospital, Toronto, Canada.

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Peter Alken
This general review offers 101 references to readers with no or limited knowledge of ESWL.
Thursday, May 02 2019 08:30
2972 Hits
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Watson RR et al., 2018: Biliary and pancreatic lithotripsy devices

ASGE Technology Committee, Watson RR, Parsi MA, Aslanian HR, Goodman AJ, Lichtenstein DR, Melson J, Navaneethan U, Pannala R, Sethi A, Sullivan SA, Thosani NC, Trikudanathan G, Trindade AJ, Maple JT.
Biliary and pancreatic lithotripsy devices.

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Peter Alken
This overview on all lithotripsy techniques to treat biliary and pancreatic stones includes a few basic general comments on ESWL.... Read More
Monday, April 29 2019 10:00
3261 Hits
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Reesink DJ et al., 2018: Extracorporeal shock wave lithotripsy under intravenous sedation for treatment of urolithiasis

Reesink DJ, Scheltema JMW, Barendrecht MM, Boeken Kruger AE, Jansonius A, Wiltink J, van der Windt F.

a Urology Department , Tergooi Hospital Hilversum/Blaricum , Blaricum , The Netherlands.

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Peter Alken
We have reviewed more than 1000 publication on EWSL and I have read a lot of other publications on different urological topics. Th... Read More
Thursday, April 25 2019 08:40
3841 Hits
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Woźniak P et al., 2018: The lipid peroxidation in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy

Woźniak P, Kontek B, Różański W, Olas B.
2nd Department of Urology, Medical University of Łódź, Pabianicka 62, 93-513 Łódź, Poland.
Department of General Biochemistry, Faculty of Biology & Environmental Protection, University of Łódź, Pomorska 141/3, 90-236 Łódź, Poland.

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Peter Alken
The core information concerning the effect of ESWL on the parameters evaluated is: no change after ESWL. The stone patients were... Read More
Tuesday, April 23 2019 08:32
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Leapman MS et al, 2018: Variation in National Opioid Prescribing Patterns Following Surgery for Kidney Stones.

Leapman MS, DeRycke E, Skanderson M, Becker WC, Makarov DV, Gross CP, Driscoll M, Motamedinia P, Bathulapalli H, Mattocks K, Brandt CA, Haskell S, Bastian LA.
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.
Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Population Health, NYU Langone Medical Center, New York, New York.
VA New York, NY Harbor Healthcare System.

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Peter Alken
The most devastating pain in urology is colicky pain. But even in this acute situation opioids are rarely given in Europe: The 20... Read More
Wednesday, January 09 2019 15:29
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Zewin TS et al, 2018: Efficacy and safety of low-intensity shock wave therapy in penile rehabilitation post nerve-sparing radical cystoprostatectomy: a randomized controlled trial.

Zewin TS, El-Assmy A, Harraz AM, Bazeed M, Shokeir AA, Sheir K, Mosbah A.
Urology Department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.

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Peter Alken
To the best of our knowledge, this is the first randomized controlled study that evaluated the use of LI-ESWT as a penile rehabili... Read More
Thursday, March 28 2019 12:56
Peter Alken
All patients suffered from postoperative ED. In the Li-ESWT group patients received 12 sessions of penile within 9 weeks while the... Read More
Monday, January 07 2019 15:25
5552 Hits
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Fan J et al, 2018: The role of super-mini percutaneous nephrolithotomy (SMP) in the treatment of symptomatic lower pole renal stones (LPSs) after the failure of shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS).

Fan J, Zhang T, Zhu W, Gurioli A, Ketegwe IR, Zeng G.
Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Urology, No. 1-3, Kangda Road, Guangzhou, Guangdong, 510230, China.
Department of Urology, Turin University of Studies, Turin, Italy.

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Peter Alken
This publication comes from a department with extensive experience in super-mini percutaneous nephrolithotomy (SMP). “All the proc... Read More
Friday, January 04 2019 15:22
4798 Hits
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Veld JV et al, 2018: A systematic review of advanced endoscopy-assisted lithotripsy for retained biliary tract stones: laser, electrohydraulic or extracorporeal shock wave.

Veld JV, van Huijgevoort NCM, Boermeester MA, Besselink MG, van Delden OM, Fockens P, van Hooft JE.
Department of Gastroenterology and Hepatology, Department of Surgery, Department of Interventional Radiology, Amsterdam Gastroenterology and Metabolism, Academic Medical Center, Amsterdam, the Netherlands.

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Peter Alken
The trend described is similar to that for the treatment of pancreatic duct stones. It is surprising to see that electrohydraulic... Read More
Wednesday, January 02 2019 15:19
4491 Hits
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Fankhauser CD et al, 2018: Extracorporeal shock wave lithotripsy versus flexible ureterorenoscopy in the treatment of untreated renal calculi.

Fankhauser CD, Hermanns T, Lieger L, Diethelm O, Umbehr M, Luginbühl T, Sulser T, Müntener M, Poyet C.
Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland.
Department of Urology, City Hospital Triemli of Zurich, Zurich, Switzerland.
Department of Urology, Spital Uster, Uster, Switzerland.

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Peter Alken
This is a good retrospective study which has the added value of a propensity score-matched analysis of a large case number and thu... Read More
Monday, December 31 2018 15:15
5251 Hits
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Gadzhiev N et al, 2018: Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy.

Gadzhiev N, Gorelov D, Smirnov A, Al-Shukri S, Petrov S.
Department of Urology, Department of Endoscopy, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russia.
Department of Urology, The Nikiforov Russian Center of Emergency and Radiation Medicine, Saint-Petersburg, Russia.

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Peter Alken
The duodenal lesion happened not as a consequence of ESWL but during the percutaneous puncture and drainage of the hematoma.... Read More
Thursday, December 27 2018 15:11
4991 Hits
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Choo MS et al, 2018: A Prediction Model using Machine Learning Algorithm for Assessing Stone-Free Status after Single-Session Shockwave Lithotripsy to Treat Ureteral Stones.

Choo MS, Uhmn S, Kim JK, Han JH, Kim DH, Kim J, Lee SH.
Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Geonggi-do, Republic of Korea; Department of Computer Engineering, Hallym University (SU, DHK, JK), Chuncheon, Gangwon-do, Republic of Korea.

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Peter Alken
This paper is worth reading because it is a new promise to predict the future. “Stone length as well as stone width and height me... Read More
Friday, December 21 2018 15:07
5059 Hits
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Proietti S et al, 2018: Italian endourological panorama: results from a national survey.

Proietti S, Somani BK, Pietropaolo A, Saitta G, Rodríguez-Socarrás ME, Rosso M, Bellinzoni P, Gaboardi F, Giusti G.
Urology Department, IRCCS San Raffaele Scientific Institute, Ville Turro Division, Milan, Italy.
Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.

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Peter Alken
An interesting article because of the data and moreover because of the discussion which touches many aspects of the urological pro... Read More
Wednesday, December 19 2018 14:59
5643 Hits
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Wang YB et al, 2018: Efficacies of Various Surgical Regimens in the Treatment of Renal Calculi Patients: a Network Meta-Analysis in 25 Enrolled Controlled Clinical Trials.

Wang YB, Cui YX, Song JN, Yang Q, Wang G.
Department of Urology, Third Operating Room, First Operating Room, Second Operating Room, the First Hospital of Jilin University, Changchun, China.

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Peter Alken
Another Network Meta-Analysis. A simple rule to avoid wasting time is: do not read meta-analyses which do not state in the introdu... Read More
Monday, December 17 2018 14:56
4668 Hits
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Zang ZJ et al, 2018: The impact of low-intensity extracorporeal shock wave therapy on testicular function in adult rats.

Zang ZJ, Liu Q, Hu J, Feng J, Zhu YQ, Ma G, Jiang MH.
Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Cell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.

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Peter Alken
Do patients have to be informed about possible testicular damage while being treated with Li-ESWT? I would say, no: “…the use of a... Read More
Tuesday, December 11 2018 14:51
4571 Hits
1 Comment

Ali M et al, 2018: Shock wave lithotripsy versus endoscopic cystolitholapaxy in the management of patients presenting with calcular acute urinary retention: a randomised controlled trial.

Ali M, Hashem A, Helmy TE, Zewin T, Sheir KZ, Shokeir AA.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

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Peter Alken
Very good results with ESWL on bladder stones integrate and clear stones in 43 patients (86%), while 2 patients required 2 session... Read More
Thursday, December 06 2018 14:48
4875 Hits
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Weigel WA et al, 2018: Process improvement for a complex dual medical procedure.

Weigel WA, Gluck M, Ross AS, Lin OS, Williams BL, Blackmore CC.
Department of Anesthesiology, Department of Radiology, Department of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington, USA.
Center for Healthcare Improvement Science, Virginia Mason Medical Center, Seattle, Washington, USA.

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Peter Alken
The article does not focus on ESWL but describes an organizational and procedural rearrangement of the combined therapy of pancrea... Read More
Tuesday, November 27 2018 14:37
6648 Hits
1 Comment

Davis RB et al, 2018: Contemporary practice patterns in the treatment of pediatric stone disease.

Davis RB, Farber NJ, Kaplan A, Patel R, Steckler RE, Elsamra SE.
Department of Urology, Rutgers-Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

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Peter Alken
No free access via Karolinska Institute and Heidelberg University
Thursday, November 22 2018 14:44
5033 Hits
1 Comment

Li PC et al, 2018: [Low-intensity extracorporeal shockwave therapy for Peyronie's disease: A preliminary study of 32 cases].

Li PC, Chen X, Zhu XB, Shi T, Song F, Huang HW, Zhang XS.
Department of Andrology, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, China.

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  5013 Hits
  1 Comment
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Peter Alken
Currently no comment available.
Tuesday, November 20 2018 14:32
5013 Hits
1 Comment

Frost F et al, 2018: Between a Rock and an Airspace: Pneumothorax After Extracorporeal Shock Wave Lithotripsy for Renal Stones in a Patient With Cystic Fibrosis.

Frost F, Griffiths P, Brockelsby C, Lynch C, Walshaw MJ, Nazareth D.
Adult CF Centre, Liverpool Heart and Chest Hospital, Liverpool, UK.
Urology Department, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK.

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  5173 Hits
  1 Comment
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Peter Alken
Currently no comment available.
Thursday, November 15 2018 11:59
5173 Hits
1 Comment

Gürbuz ZG et al, 2018: Small renal pelvis stones: Shock wave lithotripsy or flexible ureteroscopy? A match-pair analysis.

Gürbuz ZG, Şener NC, Vuruşkan E, Deniz ME, Gürlen G, Ortoğlu F.
Department of Urology, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Turkey.

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  5042 Hits
  1 Comment
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Peter Alken
In the fURS group an 11.5/9.5 F ureteral access sheath was placed in all cases obviously without problems. No patient had a primar... Read More
Friday, November 09 2018 11:55
5042 Hits
1 Comment

Fan J et al, 2018: The role of super-mini percutaneous nephrolithotomy (SMP) in the treatment of symptomatic lower pole renal stones (LPSs) after the failure of shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS).

Fan J, Zhang T, Zhu W, Gurioli A, Ketegwe IR, Zeng G.
Department of Urology, Turin University of Studies, Turin, Italy.
Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Urology, No. 1-3, Kangda Road, Guangzhou, Guangdong, 510230, China.

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  5281 Hits
  1 Comment
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Peter Alken
Good study about the percutaneous removal of lower pole stones after failed ESWL or RIRS. The only critic I have is that 9,1% of t... Read More
Tuesday, November 06 2018 12:04
5281 Hits
1 Comment

Tokgöz H et al, 2017: Lunar cycle may have an effect on Shock Wave Lithotripsy related pain outcome.

Tokgöz H, Yalçınkaya S, İslamoğlu E, Karamık K, Tokgöz Ö, Savaş M.
Antalya Training and Research Hospital, Departments of Urology, Departments of Radiology, Antalya, Turkey.

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Peter Alken
From Wikimedia :https://commons.wikimedia.org/wiki/File:Fases_lunars.png I am not familiar with the working habits at the Depart... Read More
Friday, November 02 2018 11:58
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