Long Q et al, 2015: A Prospective Randomized Controlled Trial of the Efficacy of External Physical Vibration Lithecbole after Extracorporeal Shock Wave Lithotripsy for a Lower Pole Renal Stone Less Than 2 cm.
Long Q, Zhang J, Xu Z, Zhu Y, Liu L, Wang H, Guo J, Wang G.
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
PURPOSE: We evaluate the efficacy and safety of external physical vibration lithecbole in improving the clearance rates of lower pole renal stones after shock wave lithotripsy.
MATERIALS AND METHODS: A total of 71 patients with lower pole renal stones (6 to 20 mm) were prospectively randomized into 2 groups. In the treatment group 34 patients were treated with external physical vibration lithecbole after shock wave lithotripsy. In the control group 37 patients underwent shock wave lithotripsy only. External physical vibration lithecbole was performed without anesthesia by the same team using the Friend-I External Physical Vibration Lithecbole (Fu Jian Da Medical Instrument Co., Ltd, Zhengzhou, China). The stone-free rate, stone expulsion rate, stone expulsion time and incidence of complications were monitored.
RESULTS: External physical vibration lithecbole was successful in assisting the discharge of stone fragments. The stone-free status was 76.5% in the treatment group and 48.6% in the control group (p=0.008). Stone expulsion rates at day 1, week 1 and week 3 were 76.5% (26), 94.1% (32) and 94.1% (32) in the treatment group vs 43.2% (16), 73.0% (27) and 89.2% (33) in the control group, respectively. Mean stone fragment expulsion time was 11.2 minutes in the treatment group and 9.17 hours in the control group (p=0.016). There was no significant difference in complications between the 2 groups (p >0.05).
CONCLUSIONS: External physical vibration lithecbole was efficacious in assisting the discharge of lower pole renal stone fragments and can be used as an adjunctive method of minimally invasive stone treatment. However, additional investigations are needed to confirm the efficacy.
J Urol. 2015 Nov 7. pii: S0022-5347(15)05201-5. doi: 10.1016/j.juro.2015.10.174. [Epub ahead of print]
“ESWL Plus” is what I called all procedures to improve the passage of stone fragments after ESWL. This is another publication on the very positive effects of percussion.
The interested reader should have a look at
Liu LR, Li QJ, Wei Q, Liu ZH, Xu Y. Percussion, diuresis, and inversion therapy for the passage of lower pole kidney stones following shock wave lithotripsy. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD008569.
and especially Lee, S. W.-H., Chaiyakunapruk, N., Chong, H.-Y. and Liong, M.-L. (2015), Comparative effectiveness and safety of various treatment procedures for lower pole renal calculi: a systematic review and network meta-analysis. BJU International, 116: 252–264.
The latter publication shows a superiority of ESWL-Plus versus RIRS