COMPARISON BETWEEN EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY AT 120 AND 60 SHOCKWAVES PER MINUTE FOR TREATMENT OF URINARY STONES

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  • Kashima Soki
    Department of Urology, Akita Red Cross Hospital
  • Horikawa Yohei
    Department of Urology, Akita Red Cross Hospital
  • Obara Takashi
    Department of Urology, Akita Red Cross Hospital
  • Muto Yumina
    Department of Urology, Akita Red Cross Hospital
  • Koizumi Atsushi
    Present address: Department of Urology, Akita University Graduate School of Medicine
  • Honma Naoko
    Present address: Department of Urology, Akita University Graduate School of Medicine
  • Akihama Susumu
    Present address: Department of Urology, Akita University Graduate School of Medicine
  • Shimoda Naotake
    Department of Urology, Akita Red Cross Hospital

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Other Title
  • 体外衝撃波結石破砕術（ESWL）における衝撃波照射速度120/minと60/minの比較
  • タイガイ ショウゲキハ ケッセキ ハサイジュツ(ESWL)ニ オケル ショウゲキハ ショウシャ ソクド 120/min ト 60/min ノ ヒカク

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Abstract

<p> (Purpose) It has recently been suggested that a slow delivery rate of shockwaves by extracorporeal shock wave lithotripsy (SWL) improved treatment outcomes for urinary stones. We retrospectively analyzed the treatment outcomes of different shockwave delivery rates at 120 and 60 shockwaves per minute.</p><p> (Patients and method) A total of 88 patients were treated at a fast delivery rate of 120 shockwaves per minute between July 2010 and April 2012, and 139 patients were treated at a slow delivery rate of 60 shockwaves per minute between May 2012 and May 2014 (n=227) using a Sonolith® Praktis lithotripter. The treatment outcome of stone-free rate (SFR) after one SWL session was assessed at four weeks.</p><p> (Result) SWL at 60 shockwaves per minute resulted in a significantly higher SFR compared with SWL at 120 shockwaves per minute (39.8% and 59.0%, respectively, p=0.0047), particularly for upper ureter (U1) stones (53.1% and 72.0%, respectively, p=0.028). Multivariate analysis showed that younger age, stone sizes of 10 mm or less, U1 stones, and slow delivery rate were significant predictors of a stone-free outcome. There were fewer adverse events after the delivery rate of 60 shockwaves per minute (p=0.058).</p><p> (Conclusion) Our study suggests that SWL at 60 shockwaves per minute should be recommended to successfully treat urinary stones using the Sonolith® Praktis lithotripter.</p>

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