Yu A. et al., 2026: Comparative Analysis Between Burst-Wave Lithotripsy vs Standard Ultrasound- Guided Extracorporeal Shock Wave Lithotripsy for 5-10 mm Ureteral Stones.

Yu A, Wu P.
Arch Esp Urol. 2026 Mar;79(2):298-305. doi: 10.56434/j.arch.esp.urol.20267902.36

Abstract

Background: Although burst-wave lithotripsy (BWL) and ultrasound-guided extracorporeal shock wave lithotripsy (US-guided ESWL) are used for ureteral stones, direct comparative evidence to guide optimal clinical choice between them is limited. This work aimed to compare the efficacy differences between BWL and US-guided ESWL in treating 5-10 mm ureteral stones.

Methods: This retrospective study included 100 patients with 5-10 mm ureteral stones treated between January 2022 and January 2024. The patients were divided into two groups of 50 patients each on the basis of treatment modality: the BWL group and the US-guided ESWL group. Baseline characteristics were balanced and comparable between groups ( p > 0.05). The efficacy and safety of the two therapies were systematically evaluated by comparing various indicators across both groups.

Results: For ureteral stones measuring 5-10 mm, BWL demonstrated superior outcomes in terms of stone clearance rate (88.0% vs. 64.0%), reduced retreatment rates (6.0% vs. 24.0%) and treatment costs compared with US-guided ESWL. The BWL group also demonstrated greater improvements in postoperative pain, stone passage time and quality of life (85.5 ± 5.2 vs. 80.3 ± 6.7 points, all p < 0.05). Although the procedure duration of BWL was longer, no statistically significant difference was found in the complication rates between the two groups.

Conclusions: For ureteral stones measuring 5-10 mm, BWL demonstrates significant advantages in key efficacy indicators. It should be considered the preferred treatment option.

Comment Peter Alken

I have nominated every paper on BWL published so far as reviewer’s choice. They all came from USA. This one is a real surprise.

Two Chinese Urologists, who at the time of publication were affiliated to two different clinics in two different Chinese cities in 1h45min flight distance publish in 2026 in a Spanish journal a retrospective cohort study of 100 patients with ureteral stones treated “ by the same group of physicians with over 5 years of experience to ensure consistent procedural standards.” Patients were treated between January 2022 and January 2024 with ESWL or BWL. It is not stated which machines were used.  The results with BWL are superior to those with ESWL. Otherwise I have no comment for the experienced reader

Peter Alken