scholarly journals EFFICACY OF SELECTIVE ALPHA-1 RECEPTOR BLOCKERS (TAMSULOSIN) IN FACILITATING THE PASSAGE OF RENAL STONES AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

2021 ◽  
Vol 12 (1) ◽  
pp. 36-43
Author(s):  
Dr. Nauman Khalid ◽  
Aijaz Hussain Memon ◽  
Wasim Sarwar Bhatti ◽  
Hanan Noor ◽  
Muhammad Waqas Iqbal ◽  
...  
Keyword(s):  
Shock Wave ◽  
Clearance Rate ◽  
Shock Wave Lithotripsy ◽  
Diclofenac Sodium ◽  
Renal Stones ◽  
Stone Clearance ◽  
X Ray ◽  
Group A ◽  
Group B

BACKGROUND & OBJECTIVE: Urinary system stone disease is a common entity. Small renal stones are preferably treated using Extracarporeal Shock Wave Lithotripsy (ESWL) technique. Passage of stone fragments result in pain, hematuria and urinary tract obstruction. This can be avoided by the use selective α-1 receptor antagonists like Tamsulosin. However, their efficacy remains a matter of debate. In this study the role of selective α-1 blocker was evaluated in facilitating spontaneous expulsion of renal stone fragments after ESWL. The objective of our study was to find out the Efficacy of Tamsulosin (Selective α-1 blocker) in facilitating the transit of stone fragments (4-7mm) after ESWL. Follow up X-ray KUB was used to confirm the stone clearance. Efficacy was measured in terms of stone expulsion rate. METHODOLOGY: It was randomized controlled trial including 150 patients coming to outpatient department of Urology Lahore General Hospital, Lahore from January 25, 2010­ to July 25, 2010. Total 150 patients with renal stones broken down into fragments (4-7mm) after ESWL were enrolled using non-probability purposive sampling technique. Patients were categorized into group A and B. Patients of group A received cap. Tamsulosin 0.4mg along with Tab. Diclofenac sodium 50mg. Whereas, patients belonging to group B received only diclofenac sodium 50 mg twice daily. Patients underwent ESWL every three weeks, in case of non-fragmentation, to the maximum of 4 sessions. All the patients were followed with X Ray KUB for stone clearance. The data of all patients was incorporated into pre designed Performa. Statistical evaluation of clinical variables done in terms of efficacy i.e. stone clearance. RESULTS: Stone clearance rate of patients in group A was 86.6% as compared to only 76% in group B. Usage of selective α-1 blockers in group A enhanced the stone clearance rate as compared to group B. However this difference was statistically insignificant (p-value-0.094). CONCLUSION: There was increased stone clearance in alpha one blocker group but not statistically significant. Further studies with larger sample size are required to evaluate the role of Selective α-1 blockers (Tamsulosin) after ESWL.

Comparing 60 versus 120 shocks per minute for shock-wave lithotripsy of solitary renal calculi: A controlled randomized study

2020 ◽  
pp. 205141582094592
Author(s):  
Tamer A Ali ◽  
Mohamed A Abdelaal ◽  
Moamen M Amin ◽  
Mohamed K Saif-Elnasr
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
Randomized Study ◽  
Renal Stones ◽  
Renal Calculi ◽  
Successful Outcome ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B

Objective: This study aimed to compare the difference in outcome of shock-wave lithotripsy (SWL) using a slow rate of 60 shocks per minute versus a rapid rate of 120 shocks per minute generated by an electromagnetic lithotripter for renal calculi. Methods: From May 2017 to June 2019, 156 patients ( Mage=38.7 years) with single radio-opaque renal stones smaller than 20 mm were included and randomly divided into two groups: group A, 78 patients who received 60 shocks per minute; and group B, 78 patients who received 120 shocks per minute. Patients were radiologically reviewed at 3 months for an outcome. Results: There was no statistically significant difference between mean stone area treated ( p=0.222) or additional analgesic use in the form of patient-controlled analgesia (PCA; alfentanil; p=0.82). A successful outcome was defined by fragments smaller than 4 mm or stone-free status. In group A, 60% of patients had a successful outcome compared with 61.4% in group B ( p=0.869) following a single treatment. Post-treatment complications were similar in both groups at 12% for group A and 10.7% for group B ( p=0.797). Conclusions: There was no statistically significant difference between the delivery of 60 and 120 shocks per minute during SWL for the treatment of solitary renal stones with a mean stone area of 62 mm2 regarding the outcome, complications or PCA use when using a Dornier Compact Delta II lithotripter.

scholarly journals EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY;

2012 ◽  
Vol 19 (05) ◽  
pp. 636-641
Author(s):  
ZAKIR HUSSAIN RAJPAR ◽  
JAI PAL PARYANI ◽  
SHAFIQUE-UR- REHMAN MEMON ◽  
Aziz Abdullah ◽  
Ubedullah Shaikh
Keyword(s):  
Shock Wave ◽  
Medical Therapy ◽  
Shock Wave Lithotripsy ◽  
Conventional Treatment ◽  
Renal Stones ◽  
Female Ratio ◽  
Extracorporeal Shock Wave ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of Alpha blocker as adjunctive medical therapy , which increases the stone clearance afterextracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Design: Quasi Experimental study. Setting: Department of Urology,Liaquat National Hospital, Karachi. Period: September 2010 to March 2011. Materials & Method: Ultrasound guided Dornier Alpha Impactlithotripter was used for shock wave lithotripsy. Study was carried out on 60 patients who underwent single session of ESWL for renal calculus.Patients were divided in two groups, Group A (n=30) received conventional treatment and Group B (n=30) received Alpha-1 Blocker in additionto conventional treatment. All patients were evaluated with X-ray and Ultrasound (KUB) after 2 weeks and repeated at the end of month. Failureis defined as unsuccessful expulsion after 4 weeks and patient desire to remove the stone before day 30. Result: Out of 60 patients, 45(75%)were males and 15(257%) were females with male to female ratio was 3:1. The average age of the patients was found 36.32 ± 14.8 (Rangingfrom 15 to 75) years. Complete clearance was achieved in 76.7% of those receiving Alpha-1 Blocker and in 46.7% of controls at 1 month (P =0.001). This difference was statistically significant. Conclusions: The results of my study demonstrate that Alpha-1 Blocker therapy, as anadjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equallysafe.

scholarly journals Comparative Study between Slow Shock Wave Lithotripsy and Fast Shock Wave Lithotripsy in the Management of Renal Stone

2013 ◽  
Vol 3 (1) ◽  
pp. 24-28
Author(s):  
Deb Prosad Paul ◽  
Debashish Das ◽  
ASM Zahidur Rahman ◽  
AKM Zamanul Islam Bhuiyan
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Delivery Rate ◽  
Stone Clearance ◽  
Complete Clearance ◽  
Group A ◽  
Group B

Background: Renal calculi are frequent causes of ureteric colic. Extracorporeal shock wave lithotripsy is the most common treatment of these stones. It uses focused sound waves to break up stones externally. Objective: To compare the efficiency of slow and fast delivery rate of shock waves on stone fragmentation and treatment outcome in patients with renal calculi.Materials and Methods: This prospective study was done in the department of Urology, National Institute of Kidney diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2006 to June 2007. Total 90 patients were treated using the Storz Medical Modulith ® SLX lithotripter. Patients were divided into Group A, Group B and Group C – each group having 30 subjects. Group A was selected for extracorporeal shockwave lithotripsy (ESWL) by 60 shock waves per minute, Group B by 90 shock waves per minute and Group C by 120 shock waves per minute. Results: Complete clearance of stone was observed in 24 patients in Group A and 13 patients in both Group B and Group C in first session. In Group A only 3 patients needed second session but in Group B and Group C, 12 and 8 patients needed second session. In Group A only one patient needed third session but third session was required for 3 patients in Group B and 5 patients in Group C for complete clearance of stone. In Group A, subsequent sessions were performed under spinal anesthesia and in Group B under sedation and analgesia (p>0.001). Mean number of sessions for full clearance of stones in group A was 1.37 ± 0.85, in Group B was 1.8 ± 0.887 and in Group C was 2.0 ± 1.083. Significant difference was observed in term of sessions among groups (p>0.05). In first follow-up, complete clearance of stones was seen in 24 patients in Group A and 13 in both Group B and Group C. In second follow-up, 3 patients in Group A, 12 in Group B and 8 in Group C showed complete clearance of stones. It was observed that rate of stone clearance was higher in Group A than in Group B and Group C. Multiple logistic regression analyses revealed that slow delivery rate (60 SW/min) as well as age (younger), symptom (painful) at onset, stone location (upper and middle calyx) and size (small) were independent prognostic factors determining stone clearance after ESWL of renal stone.Conclusion: Slow rate shock wave delivery improves efficacy of ESWL treatments of renal stone and decreased number of sessions, shock waves and treatment time. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13870 J Enam Med Col 2013; 3(1): 24-28

scholarly journals A Prospective Longitudinal Study onthe Predictability of Quadruple-D Score in the Success Rate of Extracorporeal Shock Wave Lithotripsy for Renal Stones 1-2cm in Diameter

2021 ◽  
Author(s):  
Soumish Sengupta ◽  
Supriya Basu ◽  
Kadambari Ghosh
Keyword(s):  
Computed Tomography ◽  
Shock Wave ◽  
Scoring System ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Extracorporeal Shock Wave ◽  
Group A ◽  
Group B ◽  
Stone Density ◽  
Free Status

Introduction: Quadruple-D, based on Computed Tomography (CT) derived metrics, is a scoring system that helps urologists to predict the Stone Free Rate (SFR) following Extracorporeal Shock Wave Lithotripsy (ESWL) in renal stones. Aim: To evaluate the efficacy of Quadruple-D scoring system to assess the SFR in individuals with renal stones measuring 1-2 cm in diameter after giving ESWL. Materials and Methods: The study was conducted on 120 patients. Systemic random sampling technique was applied with a sampling interval of two. Quadruple-D scoring, comprising of four Computed Tomography (CT) based metrics that is stonedimension, stone density, Hounsfield units (HU), Skin-to-Stone Distance (SSD) and stone location, was done prior to ESWL. The scores ranged from zero (worst) to four (best) points. Plain abdominal radiography was done three weeks after ESWL to assess SFR. Complete clearance was considered the stone free status. Patients were divided into group A with complete stone clearance and group B with residual stone. All the statistical analysis was done using IBM SPSS 26.0. Student’s t-test or Mann-Whitney U-test was used to compare continuous variables. Fisher’s-exact test and Chi-square test were used to analyse the cross charts between two categories. Results:The mean ellipsoid Stone Volume (SV) was 396.44±163.23 mm3 and 395.81±227.52 mm3 in group A and B, respectively. The stone density was 724.28±210.90 in group A and 814.56±190.63 in group B. In group A, 9.20% and in group B, 34.09% of the patients had stones in lower calyx. The difference between the groups based on the above parameters were statistically significant. The Quadruple-D score was 2.09±0.65 and 1.54±0.79 in group A and B, respectively. The Area Under the Curve (AUC) of Quadruple-D scoring system was 0.674. The age, sex, BMI, laterality of the stone and SSD did not predict stone-free status in this study. Conclusion: Quadruple-D scoring system has been successfully validated as the SFR showed a parallel increase with every positive component. Quadruple-D is an easy to use clinical tool to predict the success rate of ESWL.

scholarly journals COMPARISON OF THE SUCCESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) WITH AND WITHOUT DJ STENTING IN PROXIMAL URETERIC STONE

2020 ◽  
Vol 11 (2) ◽  
pp. 21-24
Author(s):  
Dr. Mudassar Saeed Pansota
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
P Value ◽  
Ureteric Stone ◽  
Extracorporeal Shock Wave ◽  
Dj Stent ◽  
Group A ◽  
Group B ◽  
Average Size

BACKGROUND & OBJECTIVE: There is disagreement in the use of ureteral double-J stent before the extracorporeal shock wave lithotripsy (ESWL), although most of the urologists suggest using stent in shock wave lithotripsy technique for stones bigger than 20mm, for preventing the risk of developing steinstrasse. To compare the success of ESWL with and without DJ stenting in proximal ureteric stone. METHODOLOGY: A total of 60 patients form both genders, between 15 to 55 years of age, with a single proximal ureteric stone, were included. Patients with solitary functioning kidney, multiple stones, pregnancy, pyonephrosis and sepsis were excluded. In Group-A, ESWL without DJ stenting was completed while in Group-B, ESWL with DJ stent placement was done. In all patients, at least 4 sessions were done fortnightly. Patients were followed regularly and final success was noted after one month of completion of ESWL sessions. RESULTS: The mean age was 36.85 ± 8.61 years. From 60 patients, 29 (48.33%) were men and 231 (51.67%) were women.Mean body mass index (BMI) was 28.30±2.20 kg/m . The average size of the stone was 12.47 ± 2.57 mm. Success (according to stone removal) of Group-A (ESWL without DJS) was seen in 26 (86.67%) patients while in Group-B (ESWL with DJS) was seen in 16 (53.33%) patients with P-value of 0.005. CONCLUSION: This study concluded that success (in terms of stone clearance) of extracorporeal shock wave lithotripsy (ESWL) without DJ stenting is higher compared to with DJ stenting in upper ureteric stone.

scholarly journals Extracorporeal Shockwave Lithotripsy with Tamsulosin in Clearance of Upper Ureteral Calculi- A Randomized Control Clinical Trial

2020 ◽  
Vol 23 (1) ◽  
pp. 36-42
Author(s):  
Md Safiul Alam Babul ◽  
Md Waliul Islam ◽  
Shariful Islam Khan ◽  
Mohammad Habibur Rahman ◽  
Anup Roy Chowdhury ◽  
...  
Keyword(s):  
Clearance Rate ◽  
Ureteral Stones ◽  
P Value ◽  
Ureteric Stone ◽  
Stone Size ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background of the study: Urolithiasis has an incidence in the world of about 5% and the probability of a recurrence within 5–7 years is 50% (Parmar, 2004). Exact data about its prevalence is not known in Bangladesh but it is quite common as seen in outpatient department. It is more common in northern part of the country, male suffer more than female (M:F: 3:1) (Salam, 2002). Symptomatic ureteral calculi represent the most common condition encountered by an urologist in an emergency setting (Pak, 1998). Intervention is recommended for individuals with larger stones, especially greater than 5 mm (Kupeli et al., 1998). The treatment of this pathology was revolutionized with the introduction, in the late 1980s, of extracorporeal shock wave lithotripsy (ESWL), a non-invasive technology that has become one of the primary treatments for urinary stones. Its success rates vary depending on stone size and location and by the type of lithotripter employed. Medical expulsion therapy (MET) can play a key role in support of ESWL: specifically, expulsion is done by diuretics, calcium antagonists, anti-edema agents, and alpha-blockers. A few studies have reported their effectiveness (Borghi et al., 1994, Cervenakov et al., 2002, Porpiglia et al., 2002,Dellabella et al., 2003). Objective: This study is carried out to find out the role of Tamsulos in stone clearance in patientswith upper ureteral stone after extracorporeal shock wave lithotripsy (ESWL). Methods & Material: This randomized control clinical trialwas performed in Department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBangla Nagar, Dhaka during the period from July 2015 to June 2017. A total of 70 cases with upper ureteric stone were included during the study period. Patients were selected randomly in every alternate sequence, odd numbers for experimental group, Tamsulosin+ ESWL, group A & even numbers for control group, only ESWL, group B. Stone clearance rate, number of ESWL session and stone expulsion time were evaluated. Results: In this study showed complete stone clearance one month after ESWL in Group A was 16(89%) and Group B was 16(84.21%) for stone size 6 to 10 mm. Comparison of clearance rate between two groups in stone size 6 to 10 mm was not statistically significant (p value >.05). Complete stone clearance one month after ESWL in Group A was 13(76%) and Group B was 07(43.75%) for stone size 11 to 15 mm. Comparison of clearance rate between two groups in stone size 11 to 15 mm was statistically significant (p value <.05). In this study requirement of number of ESWL sessions according to the stone size showed, in case of 6 to 10 mm stone size, average ESWL sessions 1.28±0.5 in Group A and 1.53±0.7 in Group B and in case of 11to 15 mm stone size, average ESWL sessions 1.29±0.5 in Group A and 1.62±0.7 in Group B. Comparison of ESWL sessions between two groups were statistically significant (p value <.05). In this study mean expulsion time of stone in Group A was 22.34±12.23 days and in Group B was 32.34±21.96 days. Comparison of stone expulsion time between two groups were statistically significant (p value <.05). Conclusion: Tamsulosin results in increased stone-free rates and in lower percentages of patients requiring re-treatment. Tamsulosin can be self-administered and can play a key role in the choice between tamsulosin after ESWL and only ESWL for upper ureteric stone disease treatment. Use of tamsulosin makes the expulsive medical therapy suitable for improving overall outcomes of ESWL treatment for upper ureteral stones. Tamsulosin helps in clearance of upper ureteral stones after ESWL. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.36-42

Efficacy of Tamsulosin with Extracorporeal Shock Wave Lithotripsy for Passage of Renal and Ureteral Calculi

2008 ◽  
Vol 42 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Ryan L Losek ◽  
Laurie S Mauro
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stone ◽  
Data Extraction ◽  
Renal Stones ◽  
Ureteral Stones ◽  
Control Group ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave

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.

scholarly journals The Role of Facilitation Techniques in Gonarthrosis Recovery

GYMNASIUM ◽  
2017 ◽  
Vol XVIII (2) ◽  
pp. 83
Author(s):  
Gabriela Ochiană
Keyword(s):  
Shock Wave ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Joint Mobility ◽  
Shock Wave Therapy ◽  
Group A ◽  
Group B ◽  
Recovery Program ◽  
Facilitation Techniques

Numerous studies on people with gonarthrosis refer only to electrotherapy, shock-wave therapy, radon baths, and classical physical exercise; very few studies recall only the role of facilitating techniques in restoring functional knee parameters. This study was conducted on a total of 12 subjects diagnosed with gonarthrosis divided into 2 groups, group A followed a classical recovery program and group B a program consisting of facilitation techniques for a period of 6 months with a frequency of 3 sessions per week. The results obtained confirm the hypothesis that the parameters tested: pain, joint mobility, muscle strength and stability were noticeably improved in group B those who used  FNP techniques compared to group A and the duration of the session was only 35 minutes at group B, compared to 55 minutes group A.

scholarly journals Comparison of Slow Rate versus Fast Rate Extracorporeal Shock Wave Lithotripsy in Patients with Urolithiasis

2021 ◽  
Vol 15 (6) ◽  
pp. 1921-1923
Author(s):  
Muhammad Musa Kakar ◽  
Asadullah . ◽  
Masha Khan ◽  
Ijaz Ur Rehman
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Slow Rate ◽  
Shock Wave Lithotripsy ◽  
Fast Rate ◽  
Female Patients ◽  
Extracorporeal Shock Wave ◽  
Group A ◽  
Male Patients ◽  
Group B

Objectives: To compare the success of slow rate with fast rate extracorporeal shock wave lithotripsy in patients undergoing treatment of urolithiasis. Study design: Randomized controlled trial Place & Duration of Study: This study was conducted in Urology Department of Sandeman Civil Hospital, Quetta for one year duration from 1stApril 2020 to 30thMarch 2021. Methods: Total ninety patients who were divided in two equal groups i.e. Group A in which patients received treatment with slow rate extracorporeal shock wave lithotripsy and group B in which patients received treatment with fast rate extracorporeal shock wave lithotripsy. Results: There were 32 (71.1%) male patients and 13 (28.9%) female patients in group A. In group B, there were 28 (62.2%) male patients and 17 (37.8%) female patients. Mean age in group A was 35.61+4.19 years while in group B, the mean age was 34.11+69.32 years. The success rate of slow rate extracorporeal shock wave lithotripsy was 36 (80%) and that of fast rate extracorporeal shock wave lithotripsy was 21 (46.7%) (p-<0.05). Conclusions: The slow rate extracorporeal shock wave lithotripsy is better than fast rate extracorporeal shock wave lithotripsy for elimination of urolithiasis. Keywords: Extracorporeal shock wave lithotripsy, Slow rate ESWL, Fast rate ESWL

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