ArticleUrolithiasis2024
Matched pair analysis of wide versus narrow focus during shockwave lithotripsy for urolithiasis.
Article in Urolithiasis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare stone clearance and complications between a 'wide' (9 × 50 mm) and 'narrow' shockwave focus (6 × 28 mm) when undertaking shockwave lithotripsy (SWL) in patients with renal or ureteric stones.
methodsData from patients undergoing SWL using the dual focus Storz Modulith SLX-F2 lithotripter at a single centre were prospectively collected between February 2018 and September 2020. Patients were matched by stone size, location, and number of treatments. Stone clearance, re-presentation within 31 days, symptoms, complications, and need for post SWL-interventions were compared using McNemar's test.
resultsPatients receiving wide focus SWL (WF-SWL, n = 152) were matched with patients receiving narrow focus SWL (NF-SWL, n = 152). Median stone size was 6 mm; energy delivered to WF-SWL and NF-SWL groups was comparable. Complete stone clearance was achieved in 55% of WF-SWL patients (n = 84) and 41% (n = 63) of NF-SWL patients (p = 0.04). Treatment was considered successful in 74% (n = 113) of WF-SWL cases and 66% (n = 100) of NF-SWL (p = 0.20). No difference in rates of readmission, post-procedural pain, haematuria, urinary tract infections, analgesia or antibiotic requirements were identified.
conclusionThis service evaluation demonstrates no differences in rates of overall treatment success nor complications on comparing WF-SWL and NF-SWL.
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