Effect of Medical Management and Residual Fragments on Recurrent Stone Formation Following Shock Wave Lithotripsy

1995 ◽  
Vol 153 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Joshua K. Fine ◽  
Charles Y.C. Pak ◽  
Glenn M. Preminger ◽  
Joseph W. Segura ◽  
Michael Marberger
2018 ◽  
Vol 6 ◽  
pp. 3-9
Author(s):  
Volodymir Vitkovskyy

The study objective was to analyse the effect of the herbal drug Canephron N, namely, its ability to potentiate the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of patients with urolithiasis (UL) and prevent recurrence of stone formation. Aim. To сheck the hypothesis that treatment with Canephron N can potentiate lithotripsy and reduce the risk of re-stone formation. Methodology. Patients at the age of 18 to 65 years had calcium oxalate urolithiasis with the size of the stone from 0.8 to 1.3 cm in the kidneys and from 0.5 to 0.9 cm. in ureters who underwent ESWL procedure. They were randomized into 2 equal groups of 30 people. The treatment group received general recommendations on the management of the patient with UL following ESWL and the herbal drug Canephron N for 6 months. The control group received only general recommendations. Moreover, according to condition, both groups received painkillers and spasmolytics if pain occurred during elimination of fragments. The following parameters were evaluated: the period of elimination of fragments after stone disintegration by ESWL method; the percentage of complete elimination of fragments; the presence of pain syndrome and leukocyturia in the postoperative period; the rate of recurrence of stone formation during one year after the procedure. Results. More complete and rapid elimination of fragments was observed in the treatment group. Thus, up to day 14 elimination of stone fragments was observed in 96.6 % of patients in the treatment group versus 76.6 % in the control group. Fewer cases of pain syndrome during elimination of stone fragments (23 % in the treatment group and 43 % in the control group) and rare cases of leukocyturia within 14 days (10 % versus 23 %, respectively) were observed in the treatment group. Recurrent stone formation within the year was not observed in patients of the treatment group, in the control group – in 23 % of patients. However, because of the small size of the groups, one may talk about a tendency but not about statistically significant patterns. Conclusion. Canephron N is an effective and safe drug in the treatment of patients with urolithiasis who underwent extracorporeal shock wave lithotripsy. Its use contributes to more rapid and safe elimination of fragments of destructed calculi and reduces risk of recurrent stone formation.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Elisa Cicerello ◽  
Franco Merlo ◽  
Luigi Maccatrozzo

Clinically insignificant residual fragments (CIRFs) are small fragments (less than 5 mm) that are present in upper urinary tract at the time of regular post-SWL followup. The term is controversial because they may remain silent and asymptomatic or become a risk factor for stone growth and recurrence, leading to symptomatic events, and need further urologic treatment. Although a stone-free state is the desired outcome of surgical treatment of urolithiasis, the authors believe that the presence of noninfected, nonobstructive, asymptomatic residual fragments can be managed metabolically in order to prevent stone growth and recurrence. Further urologic intervention is warranted if clinical indications for stone removal are present.


2007 ◽  
Vol 177 (5) ◽  
pp. 1785-1789 ◽  
Author(s):  
David E. Kang ◽  
Michaella M. Maloney ◽  
George E. Haleblian ◽  
W. Patrick Springhart ◽  
Emily F. Honeycutt ◽  
...  

1998 ◽  
Vol 107 (10) ◽  
pp. 860-864 ◽  
Author(s):  
Heinrich Iro ◽  
Wolf Benzel ◽  
Johannes Zenk ◽  
Thomas Schneider ◽  
Frank Waldfahrer ◽  
...  

The extracorporeal shock wave treatment of parotid stones is a rather new therapy. Its usefulness was determined in a prospective study. Seventy-six patients (36 female, 40 male, 2 to 80 years of age) with symptomatic, sonographically detectable solitary sialoliths of the parotid gland were treated with an extracorporeal piezoelectric shock wave therapy after unsuccessful conservative therapy (sialagogues, gland massage, bougienage of the secretory duct). At most, 3 treatments per patient were performed. Altogether, 38 of the 76 patients (50%) were free of stones and no longer suffered from complaints after completion of shock wave treatment and a mean follow-up period of 48 months (range 6 to 71 months). During the follow-up period, in no case could renewed stone formation be observed. Residual stone fragments were detectable in 20 patients (26%), but did not cause further symptoms. Thirteen patients (17%) with residual stone fragments stated a significant improvement of their complaints after therapy. Five patients (7%) did not observe any changes of their pretherapeutic complaints and underwent parotidectomy. The therapeutic success was not influenced by stone size or by stone localization within the gland. During the follow-up period, no side effects of the therapy were identified. With stones of the parotid gland, extracorporeal shock wave lithotripsy is — After one has used conservative therapies (sialagogues, gland massage) — the treatment of choice, avoiding in the majority of cases a parotidectomy with its operative risks (paresis of the facial nerve, Frey's syndrome).


2007 ◽  
Author(s):  
Amy E. Krambeck ◽  
Audrey L. Rohlinger ◽  
Christine M. Lohse ◽  
David E. Patterson ◽  
Matthew T. Gettman

Sign in / Sign up

Export Citation Format

Share Document