1538 USEFULNESS OF EARLY SHOCK WAVE LITHOTRIPSY IN COLIC PATIENTS WITH URETERAL STONE

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (I)1 Apr 20131538 USEFULNESS OF EARLY SHOCK WAVE LITHOTRIPSY IN COLIC PATIENTS WITH URETERAL STONE Min Chul Cho, Ki Hong Lim, Seung Baik, Jungbum Bae, Kwang Soo Lee, and Hae Won Lee Min Chul ChoMin Chul Cho Goyang, Korea, Republic of More articles by this author , Ki Hong LimKi Hong Lim Goyang, Korea, Republic of More articles by this author , Seung BaikSeung Baik Gwangju, Korea, Republic of More articles by this author , Jungbum BaeJungbum Bae Goyang, Korea, Republic of More articles by this author , Kwang Soo LeeKwang Soo Lee Goyang, Korea, Republic of More articles by this author , and Hae Won LeeHae Won Lee Goyang, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3028AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare efficacy and safety between early shock wave lithotripsy (eSWL) and deferred SWL (dSWL) in colic patients with ureter stones and to investigate whether the eSWL can play critical roles in improving treatment outcomes. METHODS A total of 372 patients who underwent SWL for single radio-opaque ureter stone of 5 ∼ 20 mm were included in this retrospective study. They were categorized into two groups according to the time between the onset of colic and SWL: eSWL (< 48 hours: n = 204) and dSWL (≥ 48 hours: n = 168) groups. Stone-free status was assessed using follow-up plain radiograph (KUB) performed at 1 week after each SWL session and repeated SWL sessions were performed immediately when follow-up KUB showed inadequate fragmentation of the stone. Success was defined as stone-free on KUB within 1 month after the first session. RESULTS There was no significant difference between the two groups regarding the baseline parameters including stone size (7.6 ± 2.5 vs. 8.3 ± 3.1 mm), location, MDRD-GFR, hydronephrosis, tissue rim sign, skin-to-stone distance (SSD) and mean Hounsfield unit. For all patients, success rate (88.2%) in the eSWL group was significantly higher than that (66.7%) in the dSWL group (Fig. 1). The eSWL group required significantly fewer SWL sessions and less time to stone-free than the dSWL group (Fig. 1). For 321 patients with stones < 10 mm, all treatment outcomes in the former group were superior to those in the latter group, while not for 51 patients with 10 ∼ 20 mm sized stones (Fig. 1). The superiority of eSWL over dSWL in the treatment outcomes was more pronounced for proximal ureter stones than mid-to-distal ureter stones (Fig. 1). Post-SWL complication rates were comparable between the two. For all patients, multivariate analysis showed that smaller stone size and the time to SWL of <48 hours were the independent predictors of success. Also, in both subgroups of 321 patients with stone size < 10 mm and 248 patients with proximal ureter stones, stone size and the time to SWL were the independent predictors. However, in 124 patients with mid-to-distal ureter stones, only the average SSD was an independent predictor. CONCLUSIONS Our data suggest that eSWL in colic patients with ureter stones is an effective and safe treatment with accelerated stone clearance, particularly in cases of stones < 10mm or proximal ureter stones. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e630-e631 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Min Chul Cho Goyang, Korea, Republic of More articles by this author Ki Hong Lim Goyang, Korea, Republic of More articles by this author Seung Baik Gwangju, Korea, Republic of More articles by this author Jungbum Bae Goyang, Korea, Republic of More articles by this author Kwang Soo Lee Goyang, Korea, Republic of More articles by this author Hae Won Lee Goyang, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...