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Shockwave Lithotripsy Effective for Midsize Stones

Stone-free rates similar for shockwave lithotripsy and ureteral laser lithotripsy

WEDNESDAY, Feb. 13 (HealthDay News) -- Shockwave lithotripsy (SWL) can be successfully used to treat intermediate-sized 10- to 15-mm proximal ureteral stones, according to an article published in Urology in January.

Seyed Amir Mohsen Ziaee, M.D., of Shaheed Labbafinezhad Hospital in Tehran, Iran, and colleagues compared therapeutic outcomes following treatment of 10- to 15-mm proximal ureteral stones with either SWL, the treatment of choice for stones less than 10 mm, or ureteroscopic laser lithotripsy (URSL), the recommended treatment for stones larger than 15 mm. The two options were explained to 197 patients with proximal ureteral stones, and patient preference guided choice of procedure.

Of the 166 patients in whom data could be analyzed, more patients opted for the less-invasive SWL (76 percent) compared to URSL (24 percent). After the three-month follow-up period, the stone-free rate between the two groups was statistically similar, with 78.6 percent of SWL patients stone-free compared to 72.5 percent of URSL patients. In addition, operative times, need for salvage procedures and post-procedure complication rates were similar across groups.

"We have shown that SWL has enough capacity for the management of proximal ureteral stones of 10 to 15 mm in size. Although ureteroscopy tends to make patients stone-free faster, because of the minimally invasive nature of SWL, patients still favored it over ureteroscopy," the authors conclude.

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