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Junuzovic D et al, 2015: Evaluation of Extracorporeal Shock Wave Lithotripsy (ESWL): Efficacy in Treatment of Urinary System Stones.

Junuzovic D, Prstojevic JK, Hasanbegovic M, Lepara Z.
Urology clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina.

Abstract

INTRODUCTION: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem.
MATERIAL AND METHODS: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation.
RESULTS: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was
present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009).
CONCLUSION: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter.

Acta Inform Med. 2014 Oct;22(5):309-14. doi: 10.5455/aim.2014.22.309-314. Epub 2014 Oct 29.

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Comments 1

Hans-Göran Tiselius on Monday, 03 August 2015 07:46

This article describes the effect of ESWL on treatment of ureteral and renal stones. The authors had used Siemens Lithostar Multiline lithotripter. It was moreover stated that the maximum number of shockwaves given during one session was 4000 and that the energy level was chosen according to the position of the stone. Details of the stone size in the different groups are not given, which in view of the way the data are presented make interpretation difficult.

Most surprising is the notation that the largest group of patients was treated with 5 sessions and that in more than 7% of the patients more than 10 treatments had been used. This result should be considered in view of the information that the SWL procedure “only on rare occasions” required mild sedation! This might indicate that the patients generally were treated with a rather low shockwave power. In as much as (in my interpretation) all patients were treated with SWL it is difficult to understand what the authors mean by 0-5 treatments in Tables 1 and 2.

The conclusion, as in most studies, was the positive correlation between stone size and number of treatments. This article would probably have been more informative if the authors had presented their findings in clear way.

This article describes the effect of ESWL on treatment of ureteral and renal stones. The authors had used Siemens Lithostar Multiline lithotripter. It was moreover stated that the maximum number of shockwaves given during one session was 4000 and that the energy level was chosen according to the position of the stone. Details of the stone size in the different groups are not given, which in view of the way the data are presented make interpretation difficult. Most surprising is the notation that the largest group of patients was treated with 5 sessions and that in more than 7% of the patients more than 10 treatments had been used. This result should be considered in view of the information that the SWL procedure “only on rare occasions” required mild sedation! This might indicate that the patients generally were treated with a rather low shockwave power. In as much as (in my interpretation) all patients were treated with SWL it is difficult to understand what the authors mean by 0-5 treatments in Tables 1 and 2. The conclusion, as in most studies, was the positive correlation between stone size and number of treatments. This article would probably have been more informative if the authors had presented their findings in clear way.
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