To evaluate the efficacy and safety of increasing the energy dose in treating urinary lithiasis with extracorporeal lithotripsy through an expanded number of Shock Waves Per Session (SWPS).
a randomized, prospective and comparative study was performed with patients with renal or ureteral lithiasis from 2011 to 2014.
Two groups were studied: Group A (n=136), treated with 3500 SWPS, and Group B (n=171), subjected to an expanded treatment with 7000 SWPS. Patients were considered stone free when there was no lithiasis or it were less or equal than 4mm after treatment. Variables related to the patient, stones, treatment and complications were collected.
The global SFR was 75,0% and 87,7% in Groups A and B respectively (p=0.004). In renal location, the SFR was higher in Group B (74,1% vs 90,7%, p=0,003) regardless of the size. In the ureteral location, there were differences in the pelvic location only (73,7% vs 95,2%). There were no differences in either the complication rate (27,2% vs25,7%, p=0,77), or the severity between the two groups. The variable "number of SWPS" was seen to be an independent predictor of the resolution of lithiasis, having the probability of resolving lithiasis 2,62 (CI95%=1,40-4,89) times greater when applying 7000 SWPS.
In our study, increasing the energy dose applied through an expanded number of shock waves per session has been shown to be more effective than standard regimens with a similar safety profile. However, more clinical studies on different types of lithotripters are required to confirm these results.
Journal of endourology. 2017 Oct 19 [Epub ahead of print]
Daniel José López-Acón, Alberto Budia, Maria Pilar Bahilo, Marta Trassierra, María de Los Ángeles Conca, Guzmán Jurado Ordaz, Francisco Boronat
Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit , Avinguda de Fernando Abril Martorell, 106 , Valencia, Spain , 46026 ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; ., Hospital Universitari i Politecnic La Fe, 16273, Lithotripsy and Endourology Unit, Valencia, Spain ; .