Immediate or delayed SWL in ureteric stones: a prospective and randomized study

The objective is to compare immediate and delayed SWL as a treatment for ureter stones between 5 and 20 mm. Patients who applied to the emergency department with single, radio opaque ureteric stone of 5–20 mm size were included in the study. Patients were randomized into immediate and delayed SWL gr...

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Bibliographic Details
Published in:Urolithiasis 2012-12, Vol.40 (6), p.739-744
Main Authors: Uguz, Sami, Senkul, Temucin, Soydan, Hasan, Ates, Ferhat, Akyol, Ilker, Malkoc, Ercan, Baykal, Kadir Vehbi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Female
Humans
Lithotripsy
Male
Medical Biochemistry
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Original Paper
Prospective Studies
Time Factors
Ureteral Calculi - therapy
Urology
Young Adult
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Summary:The objective is to compare immediate and delayed SWL as a treatment for ureter stones between 5 and 20 mm. Patients who applied to the emergency department with single, radio opaque ureteric stone of 5–20 mm size were included in the study. Patients were randomized into immediate and delayed SWL groups. SWL were carried out after pain relief in the delayed group. Maximum of three SWL sessions were applied to the patients with stones of 5 mm or bigger in diameter, leaving at least 3 days interval in-between. Stone-free rate after first session was similar in two groups. When CIRF was also considered as success, the success rate of SWL in the immediate SWL group was higher after first session ( p  = 0.02). Immediate SWL had a greater success rate in upper ureteric stones ( p  = 0.019). Overall average time required for elimination of stones was shorter in immediate SWL group than delayed SWL group ( p  = 0.033). The success rate after first SWL session (including CIRF) was 59 % for patients with chronic pain in the delayed group and 100 % for patients with acute pain in the immediate group. According to the hydronephrosis grade, success rates were 71 and 44.4 % for patients with grade 1 or no hydronephrosis in the immediate SWL group, and for patients with grade 2 or larger hydronephrosis in the delayed SWL group, respectively, after first SWL session. Immediate SWL insures stone-free status in a shorter time in cases with renal colicky pain and ureteral stones, particularly upper ureteral stones.
ISSN:0300-5623
2194-7228
1434-0879
2194-7236
DOI:10.1007/s00240-012-0490-2