Rapid Extracorporeal Shock Wave Lithotripsy Treatment after a First Colic Episode Correlates with Accelerated Ureteral Stone Clearance

2006 ◽  
Vol 49 (6) ◽  
pp. 1099-1106 ◽  
Author(s):  
Christian Seitz ◽  
Harun Fajković ◽  
Mesut Remzi ◽  
Matthias Waldert ◽  
Mehmet Özsoy ◽  
...  
2008 ◽  
Vol 42 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Ryan L Losek ◽  
Laurie S Mauro

Objective: To review the evidence for the safety and efficacy of adjunctive tamsulosin in enhancing the efficacy of renal and ureteral stone clearance when used with extracorporeal shock wave lithotripsy (ESWL). Data Sources: A search of MEDLINE (1950-January 2008), PubMed (1950-January 2008), and the Iowa Drug Information System (1966-January 2008) was performed using the search terms tamsulosin and extracorporeal shock wave lithotripsy. MeSH headings included lithotripsy and adrenergic α-antagonists. Additional references were found by searching bibliographic references of resulting citations. Study Selection and Data Extraction: All studies utilizing tamsulosin therapy after a single session of ESWL or after the development of steinstrasse, an accumulation of stone fragments that obstructs the ureter, were included. Data Synthesis: To date, 5 prospective studies have evaluated the efficacy of tamsulosin combined with ESWL in enhancing the passage of renal and ureteral stones. in one trial, 12-week renal stone clearance was 60% in the control group compared with 78.5% in the tamsulosin group (p = 0.037). Among trials that evaluated overall ureteral stone clearance, efficacy rates were 33.3-79.3% in the control groups compared with 66.6-96.6% in the tamsulosin groups. Reports of pain and supplemental analgesic dosing were consistently lower with tamsulosin, but data on the incidence of subsequent retreatment with ESWL or ureteroscopy was rarely reported. Adjunctive tamsulosin particularly enhanced the passage of renal stones 10-24 millimeters in diameter. Overall, tamsulosin was well tolerated. Conclusions: Overall, evidence suggests that adjunctive tamsulosin therapy combined with ESWL is safe and effective in enhancing stone clearance in patients with renal stones 10-24 millimeters in diameter. Evidence regarding ureteral stone clearance is inconclusive, although adjunctive tamsulosin has been reported to reduce painful episodes. Larger prospective trials evaluating different dosages and stone locations, as well as the ability of tamsulosin to reduce repeat ESWL or more invasive methods such as ureteroscopy should be performed.


Author(s):  
Fatma M. Elaiashy ◽  
Mohamed M. Abu Elyazd ◽  
Ahmed A. Eldaba ◽  
Tarek A. Gameel

Background: Thoracic paravertebral block (TPVB) produces ipsilateral somatic and sympathetic nerve blockade in multiple contiguous dermatomes both above and below the site of injection.  The Aim of This Study: was to compare the effectiveness of ultrasound-guided TPVB versus intravenous (IV) sedative analgesic using midazolam / fentanyl in patients undergoing extracorporeal shock wave lithotripsy (ESWL) procedure. Patients and Methods: This prospective, randomized study was carried out on sixty patients aged 20-60 years, with radio-opaque renal stone not more than1.5cm. TPVB group (30 patients) received ipsilateral ultrasound-guided TPVB at the level T9-T10 using bupivacaine 0.25% (20 mL) about 30 minutes before the ESWL. Midazolam/fentanyl group (30 patients) received sedatives analgesic drugs using IV midazolam (0.05 mg / kg) and fentanyl (1 µg/kg) about 5 min before the ESWL. The VAS score during and 30 min post procedure, total dose of rescue analgesic consumption during ESWL procedure, the success rate of ESWL, the time needed to stone clearance, patient and operator satisfaction scores were recorded. Result: During and after ESWL procedure, the VAS scores were significantly higher in midazolam/fentanyl group than TPVB group (P < 0.05). The number of patients required rescue analgesic during ESWL was significantly higher in midazolam/fentanyl group compared to TPVB group (P < 0.05).The success rate of ESWL was insignificantly different between both groups (P > 0.05). The time needed to stone clearance was significantly shorter in TPVB group compared to midazolam/fentanyl group (P < 0.05). Conclusions: Ultrasound-guided TPVB provided more effective analgesia with reduced number of ESWL sessions and shorter time to renal stone clearance than IV midazolam/fentanyl.


1988 ◽  
Vol 139 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Robert J. Evans ◽  
Denise D. Wingfield ◽  
Barbara A. Morollo ◽  
Alan D. Jenkins

2003 ◽  
Vol 94 (6) ◽  
pp. 626-629
Author(s):  
Yuji Kato ◽  
Kyokushin Hou ◽  
Junichi Hori ◽  
Narumi Taniguchi ◽  
Satoshi Yamaguchi ◽  
...  

2017 ◽  
Vol 24 (12) ◽  
pp. 1781-1787
Author(s):  
Iftekhar Ahmed ◽  
Muhammad Farooq ◽  
Abdul Mannan Qureshi ◽  
Muhammad Saeed ◽  
Sami Ur Rehman

Background: Urolithiasis is a common ailment that costs billions of Dollars everyyear. Recurrent urinary tract obstruction or urolithiasis may stimulate the fibrogenic flow, whichis responsible for the definite functional loss of renal parenchyma. In the few past years, themanagement of urinary calculi undertook a remarkable modification. Open surgery for stonesis nearly replaced by minimal or non-invasive operative procedures like ureterorenoscopy,percutaneous nephrolitholapaxy and extracorporeal shock wave lithotripsy (ESWL). StudyDesign: Randomized Controlled Trial. Setting: Department of Urology Services HospitalLahore. Duration of Study: 1st January -30th December 2016. Material and methods: Thecomparative study of 60 cases through Non probability convenient sampling was conducted toevaluate the outcome of ESWL in patients with single lithiasis of lower pole calyx with differentinfundibulopelvic angles as measured on pre-treatment IVU. Results: The mean age of all thepatients was 33.70±10.72 years. Out of 60 Patients 32(53.3%) were males while 28(46.7%)were females with 1.14 male to female ratio. In group A, the mean LIPA was 78.83±4.71o andin group B, was 100.53±5.73o. The overall mean LIPA of the patients was 89.68±12.11o.Stoneclearance was noted in 39 (65%) patients. 15 patients (38.46%) and 24 patients (61.53%) ingroup A and B respectively. p-value=0.015. After ESWL stone clearance was more in patientshaving IPA ≥ 90°as compared to IPA 70-90o. Conclusion: Stone clearance is significantlyhigher with IPA>90o as compared to IPA70-90o.In future now we are able to implement the useof IPA>90o instead of using <90o that is more successful in achieving stone clearance.


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