Park H. et al., 2026: A randomized controlled trial comparing efficacy, safety, and patient-reported outcomes of electroconductive and electrohydraulic extracorporeal shockwave lithotripsy.

Park H, Castillo CJ, Cho SY.
Urologia. 2026 May;93(2):241-248. doi: 10.1177/03915603251390743. Epub 2025 Nov 20.

Abstract

Objectives: To evaluate the efficacy, safety, and patient-reported outcomes, including satisfaction and pain level, of electroconductive (EC) and electrohydraulic (EH) extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureter and kidney stones in a randomized controlled trial.

Materials and methods: A total of 56 patients were randomly allocated to the EC or EH groups. Patient and stone characteristics and treatment outcomes were compared.

Results: The stone-free rates were not different between the groups. The EH group achieved the same stone-free rates as the EC group with less energy use. Pain scores were higher in the EH group (mean 4.76 ± 3.53) than in the EC group (mean 3.04 ± 2.84), with borderline significance (p = 0.063). Satisfaction scores and radiation exposure were significantly lower in the EH group than in the EC group, regardless of the stone location. Univariate and multivariate analyses identified the total number of shocks and stone location as significant predictors of stone-free status.

Conclusions: EC and EH lithotripters demonstrated comparable efficacy and complication rates across different stone locations. While the EC group showed lower pain scores and higher satisfaction, these outcomes required greater energy use and resulted in higher radiation exposure. Patient satisfaction and pain level, as patient-reported outcomes, may be considered as additional measures alongside safety and efficacy in the evaluation of ESWL modalities.

Comment Peter Alken

This is a pilot study with a new lithotripter. I do not see decisive advantages which will have an impact on EWSL in general.

Peter Alken