Nakamura K et al, 2011: Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

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Nakamura K et al, 2011: Treatment of upper urinary tract stones with extracorporeal shock wave litho...

Nakamura K et al, 2011: Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

Nakamura K, Tobiume M, Narushima M, Yoshizawa T, Nishikawa G, Kato Y, Katsuda R, Zennami K, Aoki S, Yamada Y, Honda N, Sumitomo M

Department of Urology, Aichi Medical University School of Medicine Nagakute, Aichi 480-1195, Japan

Abstract

BACKGROUND:

The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004.

METHODS:

The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL) alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment.

RESULTS:

At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]). Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each.

CONCLUSIONS:

ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

BMC Urol. 2011 Dec 12;11:26. doi: 10.1186/1471-2490-11-26

PMID:22152040[PubMed - in process] PMCID:PMC3265410

Comment

This is a report on treatment results achieved with the Sonolith lithotripter used in 226 patients, 62 with stones in the kidney and 164 with stones in the ureter. The
overall mean number of ESWL sessions was 1.62 (76 percent treated with one session). Stone-free rates after 3 months were 69% for renal stones and 92% for ureteral stones. The authors mention that the group reported was selected from 277 "candidate patients", how the selection was done is not stated, neither what happened to the remaining 51 patients.

Hans-Göran Tiselius