SWL literature
Slider

Tao RZ et al., 2018: External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy: a prospective randomized trial

Tang QL, Zhou S, Jia CP, Lv JL.

Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.

Abstract

To observe the efficacy and safety of External Physical Vibration Lithecbole (EPVL) in patients with upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy (ESWL). A total of 271 patients with upper ureteric stones 1.0-2.0 cm were prospectively randomized into two groups. One hundred and twenty-seven cases in the treatment group accepted EPVL therapy and 144 cases as control after ESWL. The stone expulsion status and stone-free rates (SFRs) between two groups were compared at the 1st, 2nd and 4th weekends by imaging examinations. All of 271 patients were randomly assigned to two groups, of which 127 patients were included in the treatment group and 144 in the control group. EPVL was successful in assisting the discharge of stone fragments. The rate of stone expulsion at day 1 in the treatment group was significantly higher than in the control group (79.5% vs. 64.6%, P = 0.006). The SFRs of the 1st weekend (76.3% vs. 61.8%, P = 0.010), the 2nd weekend (88.2% vs. 77.1%, P = 0.017) and the 4th weekend (92.1% vs. 84.0%, P = 0.042) in the treatment group were all significantly higher than that in the control group. However, no statistical significance was found in complications between the two groups (P > 0.05). Furthermore, in the treatment group the patients were treated a mean 4.3 sessions of EPVL. EPVL and ESWL are ideal complementary partners in the treatment of upper ureteric stones 1.0-2.0 cm, satisfying both high SFR and low complication. This method is safe and reproducible in clinical practice, and it also needs large-scale multicenter prospective studies further to prove the above conclusions.

Urolithiasis. 2018 Nov 28. doi: 10.1007/s00240-018-1100-8. [Epub ahead of print]

 

0
 

Комментарии 1

Peter Alken в 03.05.2019 10:43

This is the 4th publication on the the EPVL (Friend I) (1-3). The device consists of two essential pieces: a mechanical oscillator (frequency: 1300–1900/minute, amplitude 5 mm) in a table and a hand held mechanical oscillator (frequency: 2800~ 3500/minute, amplitude: 5 mm). The patient lies down on the table which can be tilted. The patient may take prone supine or lateral positions.

What I was surprised about:
These were consecutive patients. They were all treated with one ESWL session.
Obviously no patient needed a stent before or after EWSL. There were no drop-outs due to a change in the treatment protocol.

It is stated that “All through the procedure, the position changes of the stone are monitored and observed in real time by ultrasound.” In my experience it was impossible to routinely visualize ureteral stones or the ureter below the area of the lower renal pole. Equally difficult should it be to properly target the ureter with the vibrations of the handheld device and to reach the ureter below the superimposed intestine. It should be impossible to reach the ureter below the pelvic brim. I assume that most of the positive effects seen are due to the vibrations of the base plate.
The complication rate in both groups is not different but the complications listed are only dizziness, fever and perirenal hematoma. In patients treated with ureteric stones one would expect information about colics, pain treatment, stent placement etc.

1. Long Q, Zhang J, Xu Z et al (2016) 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. J Urol 195(4):965–970
2. Wu W, Yang Z, Xu C et al (2017) External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: a prospective, multicenter, randomized controlled trial. J Urol 197(5):1289–1295
3. Wu W, Yang Z, Tang F et al (2018) How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for

This is the 4th publication on the the EPVL (Friend I) (1-3). The device consists of two essential pieces: a mechanical oscillator (frequency: 1300–1900/minute, amplitude 5 mm) in a table and a hand held mechanical oscillator (frequency: 2800~ 3500/minute, amplitude: 5 mm). The patient lies down on the table which can be tilted. The patient may take prone supine or lateral positions. What I was surprised about: These were consecutive patients. They were all treated with one ESWL session. Obviously no patient needed a stent before or after EWSL. There were no drop-outs due to a change in the treatment protocol. It is stated that “All through the procedure, the position changes of the stone are monitored and observed in real time by ultrasound.” In my experience it was impossible to routinely visualize ureteral stones or the ureter below the area of the lower renal pole. Equally difficult should it be to properly target the ureter with the vibrations of the handheld device and to reach the ureter below the superimposed intestine. It should be impossible to reach the ureter below the pelvic brim. I assume that most of the positive effects seen are due to the vibrations of the base plate. The complication rate in both groups is not different but the complications listed are only dizziness, fever and perirenal hematoma. In patients treated with ureteric stones one would expect information about colics, pain treatment, stent placement etc. 1. Long Q, Zhang J, Xu Z et al (2016) 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. J Urol 195(4):965–970 2. Wu W, Yang Z, Xu C et al (2017) External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: a prospective, multicenter, randomized controlled trial. J Urol 197(5):1289–1295 3. Wu W, Yang Z, Tang F et al (2018) How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for
Гость
22.08.2019
STORZ MEDICAL AG
Lohstampfestrasse 8
8274 Tägerwilen
Switzerland
Tel.: +41 (0)71 677 45 45
Fax: +41 (0)71 677 45 05

www.storzmedical.com