Main Article Content
Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, safe and effective treatment for urinary tract lithiasis
Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive,
safe and effective treatment for urinary tract lithiasis
To evaluate the effectiveness of emergency “hot” shock wave lithotripsy in treating symptomatic ureteric/ PUJ stones.
Materials and Methods
A retrospective study looking at the emergency referrals for shock wave lithotripsy to the Churchill Hos-pital between June 2013 to Dec 2017. The Lithotripsy Database and patients’ electronic records were used to complete this project. Emergency referrals triaged by the on-call urology team and go through a renal colic clinic.
In total, 201 patients underwent emergency shock wave lithotripsy for ureteric/PUJ stones.
The mean stone size was 7.7mm (SD 2.9). 12.4% (25) were PUJ, 45.3% (91) proximal and 42.3% (85) distal ureteric stones. 1% (2) were bilateral ureteric stones. 9% (18) had previous lithotripsy treatment before being referred.
The number of shocks used was 4000 in 52.7%, >=3000 in 40.3%, >=2000 in 4.5% and >=1000 in 2.5%. The median shock frequency was 2 Hz. The median number of treatments for the targeted stone was 2. Stone fragmentation was visible in 27.4% (55), possible in 30.8% (62) and not visible in 41.8% (84).
In terms of follow up, 48.3% (97) were discharged stone-free, while 17.4% (35) were discharged with residual fragments. 21.8% (44) had further clinic follow up while 12.4% (25) had no follow-up information available, possibly because they were referred from different hospitals. 19.9% (40) needed ureteroscopy, while 7% (14) needed further lithotripsy sessions.
Emergency extracorporeal lithotripsy can be offered as an effective and safe treatment for patients with symptomatic stones.
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2. Pietropaolo A, Hendry J, Kyriakides R, et al. Outcomes of elective ureteroscopy for ureteric stones in patients with prior urosepsis and emergency drainage: prospective study over 5 yr from a tertiary endourology centre. Eur Urol Focus [Internet]. 2018 Sep [cited 2018 Sep 30]; Available at: https://linkinghub.elsevier.com/retrieve/ pii/S2405456918302517
3. Arcaniolo D, De Sio M, Rassweiler J, et al. Emergent versus delayed lithotripsy for obstructing ureteral stones: a cumulative analysis of comparative studies. Urolithiasis 2017;45(6):563–72.
4. Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones : American Urological Associa-tion / Endourological Society Guideline , PART II. J Urol [Internet]. 2016;196(4):1161–9. Available from: http://dx.doi.org/10.1016/j.juro.2016.05.091
5. Türk C, Neisius A, Petrik A, Seitz C, Thomas K, et al. EAU Guidelines on Urolithiasis. 2019.
6. NICE. Renal and ureteric stones: assessment and man-agement. NICE Guidel [NG118]. 2019;(January):1–12.
7. Kumar A, Jain M, Prakash S, Mohanty N. 1463 A pro-spective randomized comparison between early (< 48 hours of onset of colicky pain) versus delayed shock wave lithotripsy for symptomatic upper ureteric calculi:a single centre experience. J Urol 2010;183(4S):2059–66.
8. Uguz S, Senkul T, Soydan H, et al. Immediate or delayed SWL in ureteric stones: A prospective and randomized
study. Urol Res 2012;40(6):739–44.
9. Deliveliotis C, Chrisofos M, Albanis S, Serafetinides E,
Varkarakis J, Protogerou V. Management and follow-up of impacted ureteral stones. Urol Int 2003;70(4):269–72.
10. Picozzi SCM, Ricci C, Gaeta M, et al. Urgent shock wave lithotripsy as first-line treatment for ureteral stones: A meta-analysis of 570 patients. Urol Res 2012;40(6):725–31.
11. Ceylan Y, Ucer O, Bozkurt O, et al. The effect of SWL and URS on health-related quality of life in proximal ureteral stones. Minim Invasive Ther Allied Technol [Internet] 2018;27(3):148–52. Available at: https://doi. org/10.1080/13645706.2017.1350719
12. Choo MS, Uhmn S, Kim JK, et al. A prediction model using machine learning algorithm for assessing stone-free status after single session shock wave lithotripsy to treat ureteral stones. J Urol [Internet] 2018;200(6):1371–7. Available from: https://doi.org/10.1016/j.juro.2018.06.077