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World Journal of Urology

, Volume 36, Issue 2, pp 293–298 | Cite as

How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for < 15 mm upper urinary stones: a prospective multi-center randomized controlled trial about external physical vibration lithecbole (EPVL)

  • Wenqi Wu
  • Zhou Yang
  • Fengling Tang
  • Changbao Xu
  • Youzhi Wang
  • Xiaojian Gu
  • Xuehua Chen
  • Rongjiang Wang
  • Jiaka Yan
  • Xiang Wang
  • Wenxi Gao
  • Chunhua Hou
  • Jianming Guo
  • Jian Zhang
  • Alberto Gurioli
  • Zhangqun YeEmail author
  • Guohua ZengEmail author
Original Article

Abstract

Objective

To asset the efficacy and safety of EPVL plus ESWL compared with ESWL alone for the treatment of simple upper urinary stones (< 15 mm).

Materials and methods

All patients with upper urinary stones (< 15 mm) were prospectively randomized into two groups. In treatment group, patients were assigned to immediate EPVL after ESWL, while in control group, ESWL alone was offered. All patients were reexamined at 1, 2, and 4 weeks after ESWL. Stone size, stone location, stone-free rate (SFR), and complication rate were compared.

Results

56 males and 20 females in treatment group were compared to 52 male and 25 females in control group (p = 0.404). Median ages were 42.9 ± 1.5 years in treatment group and 42.7 ± 1.3 years in control group (p = 0.943). Median stone size was 10.0 ± 0.4 mm (3–15 mm) in treatment group and 10.4 ± 0.4 mm (4–15 mm) in control group (p = 0.622). The stone clearance rate in treatment and control group at 1 week after ESWL was 51.3% (39/76) and 45.4% (35/77) (p > 0.05), at 2 weeks was 81.6% (62/76) and 64.9% (50/77) (p < 0.05), and at 4 weeks was 90.8% (69/76) and 75.3% (58/77) (p < 0.05), respectively.

Conclusions

EPVL is a noninvasive, effective, and safe adjunctive treatment which increases and accelerates upper urinary stones discharge after ESWL treatment.

Keywords

EPVL ESWL Upper urinary stone Randomized controlled trial 

Notes

Acknowledgements

We appreciate the help of our colleagues from the department of 8 hospitals. In addition, we would like to express our sincere thanks to professor Alberto Gurioli for his excellent comments and suggestions in the preparation of the article.

Author contributions

GZ: project development and data analysis. ZY: project development and data analysis. WW: data collection and manuscript writing. ZY: data collection and manuscript writing. FT, CX, YW, XG, XC, RW, JY, XW, WG, CH, JG, and JZ: data collection. AG: manuscript writing

Compliance with ethical standards

Funding

This study was supported in part by research grants from Science and Technology Project of Guangzhou (201604020001 and 201607010359), General Project of Guangzhou Education Bureau (1201410963), National Natural Science Foundation of China (81570633), and Educational Commission of Guangdong Province of China (2015KTSCX115).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Trinchieri A, Ostini F, Nespoli R, Rovera F, Montanari E, Zanetti G (1999) A prospective study of recurrence rate and risk factors for recurrence after a first renal stone. J Urol 162:27–30CrossRefPubMedGoogle Scholar
  2. 2.
    Moe OW (2006) Kidney stones. Pathophysiology and medical management. Lancet 367:333–334CrossRefPubMedGoogle Scholar
  3. 3.
    Miller Nicole L, Lingeman James E (2007) Management of kidney stones. BMJ 334:468–472CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Morgan Monica S C, Pearle Margaret S (2016) Medical management of renal stones. BMJ 352:i52CrossRefPubMedGoogle Scholar
  5. 5.
    Chaussy C, Brendel W, Schmiedt E (1980) Extracorporeally induced destruction of kidney stones by shock waves. Lancet 13:1265–1268CrossRefGoogle Scholar
  6. 6.
    Wen CC, Nakada SY (2007) Treatment selection and outcomes: renal calculi. Urol Clin North Am 34:409–419CrossRefPubMedGoogle Scholar
  7. 7.
    Torricelli FC, Danilovic A, Vicentini FC, Marchini GS, Srougi M, Mazzucchi E (2015) Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones. Rev Assoc Med Bras 61:65–71CrossRefPubMedGoogle Scholar
  8. 8.
    Coz F, Orvieto M, Bustos M et al (2000) Extracorporeal shockwave lithotripsy of 2000 urinary. J Endourol 14:239–246CrossRefPubMedGoogle Scholar
  9. 9.
    White W, Klein F (2006) Five-year clinical experience with the Dornier Delta lithotriptor. Urology 68:28–32CrossRefPubMedGoogle Scholar
  10. 10.
    Abe T, Akakura K, Kawaguchi M et al (2005) Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single Institution. J Endourol 19:768–773CrossRefPubMedGoogle Scholar
  11. 11.
    Donaldson JF, Lardas M, Scrimgeour D et al (2015) Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones. Eur Urol 67:612–616CrossRefPubMedGoogle Scholar
  12. 12.
    Delvecchio FC, Preminger GM (2000) Management of residual stones. Urol Clin North Am 27:347–354CrossRefPubMedGoogle Scholar
  13. 13.
    Junuzovic D, Prstojevic JK, Hasanbegovic M, Lepara Z (2014) Evaluation of extracorporeal shock wave lithotripsy (ESWL): efficacy in treatment of urinary system stones. Acta Inform Med 22:309–314CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Inoue T, Murota T, Okada S et al (2015) Influence of pelvicaliceal anatomy on stone clearance after flexible ureteroscopy and holmium laser lithotripsy for large renal stones. J Endourol 29:998–1005CrossRefPubMedGoogle Scholar
  15. 15.
    Telegrafo M, Carluccio DA, Rella L, Ianora AA, Angelelli G, Moschetta M (2016) Diagnostic and prognostic role of computed tomography in extracorporeal shock wave lithotripsy complications. Urol Ann 8:168–172CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Raja A, Hekmati Z, Joshi HB (2016) How do urinary calculi influence health-related quality of life and patient treatment preference: a systematic review. J Endourol 30:727–743CrossRefPubMedGoogle Scholar
  17. 17.
    Argyropoulos AN, Tolley DA (2010) Evaluation of outcome following lithotripsy. Curr Opin Urol 20:154–158CrossRefPubMedGoogle Scholar
  18. 18.
    D’a Honey RJ, Luymes J, Weir MJ, Kodama R, Tariq N (2000) Mechanical percussion inversion can result in relocation of lower pole stone fragments after shock wavelithotripsy. Urology 55:204–206CrossRefPubMedGoogle Scholar
  19. 19.
    Pace KT, Tariq N, Dyer SJ, Weir MJ, D’A Honey RJ (2001) Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol 166:2065–2071CrossRefPubMedGoogle Scholar
  20. 20.
    Chiong E, Hwee ST, Kay LM, Liang S, Kamaraj R, Esuvaranathan K (2005) Randomized controlled study of mechanical percussion, diuresis, and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy. Urology 65:1070–1074CrossRefPubMedGoogle Scholar
  21. 21.
    Albanis S, Ather HM, Papatsoris AG et al (2009) Inversion, hydration and diuresis during extracorporeal shock wave lithotripsy: does it improve the stone-free rate for lower pole stone clearance? Urol Int 83:211–216CrossRefPubMedGoogle Scholar
  22. 22.
    Wu W, Yang Z, Xu C et al (2017) External Physical Vibration Lithecbole promote the stone clearance of upper urinary stone after retrograde intrarenal surgery: a prospective multi-center randomized controlled trial. J Urol.  https://doi.org/10.1016/j.juro.2017.01.001 (Epub ahead of print) Google Scholar
  23. 23.
    Long Q, Zhang J, Xu Z et al (2016) A prospective randomized controlled trial of the efficacy of external physical for a lower pole renal stone < 2 cm in a single center. J Urol 195:965–970CrossRefPubMedGoogle Scholar
  24. 24.
    Buchholz NP, Meier-Padel S, Rutishauser G (1997) Minor residual fragments after extracorporeal shockwave lithotripsy: spontaneous clearance or risk factor for recurrent stone formation? J Endourol 11:227–232CrossRefPubMedGoogle Scholar
  25. 25.
    Schmidt S, Wilhelm K (2015) Percussion, diuresis, and inversion therapy for the passage of lower pole kidney stones following shockwave lithotripsy. Urology 54:1609–1612CrossRefGoogle Scholar
  26. 26.
    Tracy CR, McLeroy SL, Best SL, Gnade BE, Pearle MS, Cadeddu JA (2010) Rendering stone fragments paramagnetic with iron-oxide microparticles improves the efficiency and effectiveness of endoscopic stone fragment retrieval. Urology 76:1266.e10-4CrossRefPubMedGoogle Scholar
  27. 27.
    Mandal S, Goel A, Kathpalia R (2012) Focused ultrasound to expel calculi from the kidney. J Urol 188:1050–1051CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Wenqi Wu
    • 1
  • Zhou Yang
    • 1
  • Fengling Tang
    • 1
  • Changbao Xu
    • 2
  • Youzhi Wang
    • 2
  • Xiaojian Gu
    • 3
  • Xuehua Chen
    • 3
  • Rongjiang Wang
    • 4
  • Jiaka Yan
    • 4
  • Xiang Wang
    • 5
  • Wenxi Gao
    • 6
  • Chunhua Hou
    • 6
  • Jianming Guo
    • 7
  • Jian Zhang
    • 7
  • Alberto Gurioli
    • 8
  • Zhangqun Ye
    • 5
    Email author
  • Guohua Zeng
    • 1
    Email author
  1. 1.Department of Urology, Minimally Invasive Surgery CenterThe First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of UrologyGuangzhouChina
  2. 2.Department of UrologyThe Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  3. 3.Department of UrologyThe Chinese Medicine Hospital of Jiangsu ProvinceNanjingChina
  4. 4.Department of UrologyThe People’s Hospital of HuzhouHuzhouChina
  5. 5.Department of UrologyThe Tongji Hospital of Huazhong Science and Technology UniversityWuhanChina
  6. 6.Department of UrologyThe Chinese Medicine Hospital of Hubei ProvinceWuhanChina
  7. 7.Department of UrologyThe Zhongshan Hospital of Fudan UniversityShanghaiChina
  8. 8.Department of UrologyTurin University of StudiesTurinItaly

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