Zou X. et al., 2026: Application of Intelligent Continuous Nursing via WeChat Platform in Patients After ESWL: A Single-center Retrospective Study Based on Dual Endpoints of Stone Expulsion Efficacy and Complications.

Zou X, Liu X, Yang Y, Zhao H, Zhu C, Xu N.
Urology. 2026 Jan;207:131-136. doi: 10.1016/j.urology.2025.11.002

Abstract

Objective: To evaluate the application effect of WeChat-based intelligent continuous nursing compared with conventional continuous nursing in patients undergoing extracorporeal shock wave lithotripsy (ESWL).

Methods: A retrospective analysis was performed on 301 outpatients who underwent ESWL in our hospital from January to December 2024. The patients were divided into a conventional continuous nursing control group (148 cases from January to June) and a WeChat-based intelligent continuous nursing observation group (153 cases from July to December). Both groups were followed up for 1 week to 3 months postoperatively. The primary outcomes included stone expulsion efficacy, complication incidence, self-care ability, and nursing satisfaction.

Results: There were no significant differences in baseline characteristics between the two groups, including age, gender, education level, stone location, stone size, total number of lithotripsy sessions, and stone clearance rate at 1 week postoperatively (all P > 0.05). The observation group showed significantly higher stone clearance rates at 2 weeks (77.1% vs. 60.8%, P < 0.01), 4 weeks (90.2% vs. 81.8%, P < 0.05), and 3 months (97.4% vs. 90.5%, P < 0.05) than the control group. The total complication rate was lower in the observation group (17% vs. 27%, P < 0.05). All four dimensions of self-care ability and overall nursing satisfaction were significantly better in the observation group (P < 0.001).

Comment Hans-Göran Tiselius

This report clearly shows that careful follow-up and instructions after SWL are of great importance and might be factors that give optimal success.

The authors obviously have a basic understanding of this mechanism because advanced postoperative advice was applied in both groups: control and observation. In the control group by a 4-page written instruction and in the observation group by a careful and extensive follow-up in which a “We-Chat” platform was used.

In the controls there were monthly in-person health follow-up, while an extensive follow-up and educational system was used to deliver advice by a team of five health care providers. The details can be found and studied in the Methods description.

Importantly, stone expulsion after 4 weeks was 90.2% in the observation group and 61% in the controls.

Undoubtedly, the extensive advice system used in the observation group is associated with a significant cost, because it is shown that the nursing team (5 persons) spent approximately 8h per person on group management.

This report clearly shows that for successful SWL it is not enough with one or several SWL sessions but also an in-depth follow-up system with continuous advice and support.

With such an approach I am sure that the results of SWL in the world would be markedly improved. Obviously however, not without personal efforts and cost.

Hans-Göran Tiselius