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Extracorporeal Shock Wave Lithotripsy (ESWL)

A method of breaking up bile stones, gallstones, and pancreatic and renal stones that uses a specialized tool and shock waves. NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

The value of ureteral stent placement before extracorporeal shock wave lithotripsy: a meta-analysis

Bibliographic details: Shao YS, Huang X.  The value of ureteral stent placement before extracorporeal shock wave lithotripsy: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2010; 10(11): 1293-1301

A systematic review and meta-analysis of new onset hypertension after extracorporeal shock wave lithotripsy

OBJECTIVE: Previous studies on the association between extracorporeal shock wave lithotripsy (SWL) and new onset hypertension have only illustrated contradictory results. In order to illustrate the association between SWL and new onset hypertension, a meta-analysis of case-control and cohort studies was conducted.

A meta-analysis of the efficacy of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi

PURPOSE: To re-evaluated the clinic efficacy of ureteroscopic lithotripsy (URS) and extracorporeal shock wave lithotripsy (ESWL) on ureteral calculi with Cochrane systematic reviews in this paper.

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Summaries for consumers

Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Stones in the urinary tract are a common medical problem. Half of patients with previous urinary stones have a recurrence within 10 years. Kidney stones can cause pain, blood in the urine, infection, decreased kidney function, and kidney failure. The treatment is to remove the stones from kidney. Extracorporeal shock wave lithotripsy (ESWL) disintegrates stones using shock waves and is a minimally invasive technique. Other minimally invasive methods (percutaneous nephrolithotomy (PCNL)) and retrograde intrarenal surgery (RIRS)) are widely used for kidney stones management because ESWL had limited success rate. This review aimed to compare the effectiveness and complications between ESWL and stones removing using the nephroscopy through the skin at kidney level (PCNL) or ureteroscope through the bladder and ureter to the kidney (RIRS). Five small randomised studies (338 patients) were included. Four studies compared ESWL with PCNL and one study compared ESWL with RIRS. Patients with kidney stones who undergo PCNL have a higher success rate than ESWL whereas RIRS was not significantly different from ESWL. However, ESWL patients spent less time in hospital, duration of treatment was shorter and there were fewer complications.

Can percussion, diuresis, and inversion therapy improve outcomes for people with lower pole kidney stones following shock wave lithotripsy?

Lower pole kidney stones are challenging to treat effectively. Many people with lower pole kidney stones undergo shock wave lithotripsy to break up stones so they can be passed from the body in the urine. In some cases, stone fragments can be retained, and these can be difficult to eliminate. Better techniques are needed to help people pass small lower pole kidney stones or fragments that remain following shock wave lithotripsy.

People who undergo ureteroscopy for the treatment of stones achieve a higher stone‐free rate, but have more complications and longer hospital stay

Ureteral stones (kidney stones that move down the ureter) frequently lead to renal colic, causing pain, and if left untreated, can block the urinary tract (obstructive uropathy). Both ureteroscopy (an examination by a doctor to see inside the urinary tract) and extracorporeal shock wave lithotripsy (ESWL, a procedure that uses high‐energy shockwave to break up stones into small particles that are passed out of the body in urine) achieve high success rates in managing ureteric stone disease. We analysed reports from seven randomised controlled trials of 1205 patients and found that ureteroscopy provided a better stone‐free rate after treatment, but patients had to stay in hospital longer, and there was a higher risk of complications. We found that there were many variations among the seven studies in their design, duration, and data collected which made comparison and evaluation challenging. We recommend that further evaluation and research is conducted to ensure that new and improved treatments and studies are considered to inform clinical practice.

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More about Extracorporeal Shock Wave Lithotripsy

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Also called: Extracorporeal Shockwave Lithrotripsy

Other terms to know:
Renal Calculi (Kidney Stones)

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