Extracorporeal Shock wave Lithotripsy (ESWL) for Ureteric Stones:
The New Gold Standard
BAUS ePoster online library. Matanhelia M. Jun 24, 2019; 259455; P1-10
Mudit Matanhelia
Mudit Matanhelia
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Abstract
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INTRODUCTION

Extracorporeal Shockwave Lithotripsy (ESWL) has good stone free rates and minimal complications. Conflicting results have been reported for the use of ESWL for radio-opaque ureteric stones. We review results for ureteric stone ESWL in one of the largest ESWL units in the United Kingdom.

METHODS

The prospective database was interrogated for patients undergoing ESWL for ureteric stones. All patients were treated with fluoroscopic and/or ultrasound guidance, in a high volume specialist stone unit with a fixed site lithotripter and dedicated staff. Outcomes included stone free rate (SFR), number of treatments, and need for adjunct procedures.

RESULTS

Over a three year period ending 2017, 399 patients underwent ESWL for ureteric stones. Mean age was 52 years (18 – 87 years), and male to female ratio was 3.5:1. Mean stone size was 7.3mm (3 – 20mm). Stones were located in the upper (48%), mid (7%), or lower ureter (45%).

Overall SFR was 71%. Stones <10mm (n=328) had a SFR of 77%, compared to 41% for larger stones. Patients with ureteric stents had a lower SFR of 31% compared to 78% in stent-free patients. 60% (n=155) of patients required only one session to be stone free, with 95% stone free after two sessions.

CONCLUSION

ESWL offers a 78% SFR in patients with radio-opaque treatment naive ureteric stones. 60% of patients required only one session. Stones larger than 10mm had a 41% success rate. This study validates the call for larger centres to offer ureteric stone ESWL as the gold standard treatment choice.
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