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Open Access 03-06-2022 | Original Article

Predictors of successful emergency shock wave lithotripsy for acute renal colic

Authors: Adel Kurkar, Ahmad A. Elderwy, Mahmoud M. Osman, Islam F. Abdelkawi, Mahmoud M. Shalaby, Mohamed F. Abdelhafez

Published in: Urolithiasis | Issue 4/2022

Abstract

The role of emergency shockwave lithotripsy (SWL) in persistent pain control in patients with ureteral stones is not well established. The aim of this study is to evaluate efficacy as well as the predicting variables for successful early SWL patients with symptomatic ureteral stones. Eighty-six patients with a persistent renal colic secondary to single ureteral stone (6–12 mm) were prospectively enrolled in this study. SWL was performed within 24 h of the onset of flank pain. Pain control and stone-free rate after emergency SWL session were 58.1% and 44.2%, respectively. Seven patients required post-SWL ureteroscopy and ureteral stent placement for uncontrolled pain. The overall 3-month stone-free rate after SWL monotherapy was 83.7%. On multivariate analysis, predictors for pain relief after emergency SWL were lower Hounsfield (HU) stone density, mild hydronephrosis (HN) at presentation and presentation during the first colic episode. Lower HU stone density was the single predictor of successful stone clearance after single emergency SWL session on multivariate analysis. In conclusion, early SWL is feasible and effective in management of ureteral stones presented by renal colic with low HU.

Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J et al (2017) Epidemiology of stone disease across the world. World J Urol 35(9):1301–1320. https://doi.org/10.1007/s00345-017-2008-6CrossRefPubMed

Park J, Suh B, Lee MS, Woo SH, Shin DW (2016) National practice pattern and time trends in treatment of upper urinary tract calculi in korea: a nationwide population-based study. J Korean Med Sci 31(12):1989–1995. https://doi.org/10.3346/jkms.2016.31.12.1989CrossRefPubMedPubMedCentral

Engeler DS, Schmid S, Schmid HP (2008) The ideal analgesic treatment for acute renal colic–theory and practice. Scand J Urol Nephrol 42(2):137–142. https://doi.org/10.1080/00365590701673716CrossRefPubMed

Afshar K, Jafari S, Marks AJ, Eftekhari A, MacNeily AE (2015) Nonsteroidal anti-inflammatory drugs (NSAIDs) and non-opioids for acute renal colic. Cochrane Database System Rev (6):CD006027. https://doi.org/10.1002/14651858.CD006027.pub2

Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69(3):468–474. https://doi.org/10.1016/j.eururo.2015.07.040CrossRefPubMed

Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482. https://doi.org/10.1016/j.eururo.2015.07.041CrossRefPubMed

Arcaniolo D, De Sio M, Rassweiler J, Nicholas J, Lima E et al (2017) Emergent versus delayed lithotripsy for obstructing ureteral stones: a cumulative analysis of comparative studies. Urolithiasis 45(6):563–572. https://doi.org/10.1007/s00240-017-0960-7CrossRefPubMed

Drake T, Grivas N, Dabestani S, Knoll T, Lam T et al (2017) What are the benefits and harms of ureteroscopy compared with shock-wave lithotripsy in the treatment of upper ureteral stones? A Systematic Review. Eur Urol 72(5):772–786. https://doi.org/10.1016/j.eururo.2017.04.016CrossRefPubMed

Cui X, Ji F, Yan H, Ou TW, Jia CS et al (2015) Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis. Urology 85(4):748–756. https://doi.org/10.1016/j.urology.2014.11.041CrossRefPubMed

10.

Tombal B, Mawlawi H, Feyaerts A, Wese FX, Opsomer R et al (2005) Prospective randomized evaluation of emergency extracorporeal shock wave lithotripsy (ESWL) on the short-time outcome of symptomatic ureteral stones. Eur Urol 47(6):855–859. https://doi.org/10.1016/j.eururo.2005.03.006CrossRefPubMed

11.

Bucci S, Umari P, Rizzo M, Pavan N, Liguori G et al (2018) Emergency extracorporeal shockwave lithotripsy as opposed to delayed shockwave lithotripsy for the treatment of acute renal colic due to obstructive ureteral stone: a prospective randomized trial. Minerva Urol Nefrol 70(5):526–533. https://doi.org/10.23736/S0393-2249.18.03084-9CrossRefPubMed

12.

Kumar A, Mohanty NK, Jain M, Prakash S, Arora RP (2010) A prospective randomized comparison between early (<48 hours of onset of colicky pain) versus delayed shockwave lithotripsy for symptomatic upper ureteral calculi: a single center experience. J Endourol 24(12):2059–2066. https://doi.org/10.1089/end.2010.0066CrossRefPubMed

13.

Liu CS, Zhang P, Shao ZQ, Zheng SB (2010) Extracorpreal shockwave lithotripsy in treatment of bilateral ureteral calculi with renal colic during emergency. J Southern Med University 30(1):189–190

14.

Panah A, Patel S, Bourdoumis A, Kachrilas S, Buchholz N et al (2013) Factors predicting success of emergency extracorporeal shockwave lithotripsy (eESWL) in ureteric calculi–a single centre experience from the United Kingdom (UK). Urolithiasis 41(5):437–441. https://doi.org/10.1007/s00240-013-0580-9CrossRefPubMed

15.

Cornelius J, Zumbuhl D, Afferi L, Mordasini L, Di Bona C et al (2021) Immediate shockwave lithotripsy vs delayed shockwave lithotripsy after urgent ureteral stenting in patients with ureteral or pyeloureteral urolithiasis: a matched-pair analysis. J Endourol 35(5):721–727. https://doi.org/10.1089/end.2020.0384CrossRefPubMed

16.

Ghalayini IF, Al-Ghazo MA, Khader YS (2008) Evaluation of emergency extracorporeal shock wave lithotripsy for obstructing ureteral stones. Int Braz J Urol 34(4):433–440. https://doi.org/10.1590/s1677-55382008000400005CrossRefPubMed

Title: Predictors of successful emergency shock wave lithotripsy for acute renal colic
Authors: Adel Kurkar
Ahmad A. Elderwy
Mahmoud M. Osman
Islam F. Abdelkawi
Mahmoud M. Shalaby
Mohamed F. Abdelhafez
Publication date: 03-06-2022
Publisher: Springer Berlin Heidelberg
Published in: Urolithiasis / Issue 4/2022
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-022-01332-3

At a glance: The STEP trials

Springer Medicine

Predictors of successful emergency shock wave lithotripsy for acute renal colic

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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