Skip to main content

Advertisement

Log in

How painful are shockwave lithotripsy and endoscopic procedures performed at outpatient urology clinics?

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

Abstracts

Our aim was to investigate the subjective pain felt by patients during shockwave lithotripsy (SWL) and endoscopic procedures such as cystoscopy, retrograde ureteral stenting, retrograde pyelography (RGP), and ureteroscopic lithotripsy performed in an outpatient clinic, and to identify how severe pain during such procedures is. We estimated subjective pain in 984 patients after SWL (186), cystoscopy (489), retrograde ureteral stenting (127), RGP (97), and ureteroscopic lithotripsy (85) performed by a single expert in an outpatient clinic using a prospective questionnaire with a ten point visual analog scale between January 2001 and December 2003. There was no premedication in any procedure except ureteroscopic lithotripsy for which an intramuscular injection of analgesics (pethidine HCl 50 mg) was used. The pain scale score in SWL was 6.62±2.27, the highest among the procedures (P<0.05). Pain scores for endoscopies were 4.48±2.07 in retrograde ureteral stenting, 3.81±2.06 in ureteroscopic lithotripsy, 3.72±1.75 in RGP, and 3.08±1.95 in cystoscopy. In this study, we observed that patients feel most pain in SWL without anesthesia, and that pain during ureteroscopic lithotripsy under local anesthesia is not high, compared with other endoscopic procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Yalcinkaya F, Topaloglu H, Unal S et al. (1996) Is general anaesthesia necessary for URS in women? Int Urol Nephrol 28: 153

    CAS  PubMed  Google Scholar 

  2. Abdel-Razzak O, Bagley DH (1993) The 6.9 F semirigid ureteroscope in clinical use. Urology 41: 45

    Article  CAS  PubMed  Google Scholar 

  3. Vogeli TA, Mellin HE, Ackermann R et al. (1993) Ureteroscopy under local anaesthesia with and without intravenous analgesia. Br J Urol 72: 161

    CAS  PubMed  Google Scholar 

  4. Schelling G, Weber W, Cullmann H et al. (1996) Patient controlled analgesia for shock wave lithotripsy: the effect of self-administered alfentanil on pain intensity and drug requirement. J Urol 155: 43

    Article  CAS  PubMed  Google Scholar 

  5. Dawson C, Vale JA, Whitfield HN et al. (1994) Choosing the correct pain relief for extracorporeal lithotripsy. Br J Urol 74: 302

    CAS  PubMed  Google Scholar 

  6. Chin CM, Tay KP, Chng HC et al. (1997) Use of patient-controlled analgesia in extracorporeal shockwave lithotripsy. Br J Urol 79: 848

    CAS  PubMed  Google Scholar 

  7. Jermini FR, Danuser H, Studer UE et al. (2002) Noninvasive anesthesia, analgesia and radiation-free extracorporeal shock wave lithotripsy for stones in the most distal ureter: experience with 165 patients. J Urol 168: 446

    Article  CAS  PubMed  Google Scholar 

  8. Ellerkmann RM, Dunn JS, Blomquist JL et al. (2003) A comparison of anticipated pain before and pain rating after the procedure in patients who undergo cystourethroscopy. Am J Obstet Gynecol 189: 66

    Article  PubMed  Google Scholar 

  9. Pliskin MJ, Kreder KJ, Dresner ML (1989) Cocaine and lidocaine as topical urethral anesthetics. J Urol 141: 1117

    CAS  PubMed  Google Scholar 

  10. Walsh PC, Retik AB, Wein AJ (2002) Campbell’s urology. WBSaunders,Philadelphia, p 119

  11. Chaussy C, Schmiedt E, Walther V et al. (1982) First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127: 417

    CAS  PubMed  Google Scholar 

  12. Drach GW, Dretler S, Newman D et al. (1986) Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127

    CAS  PubMed  Google Scholar 

  13. Mobley TB, Myers DA, Jordan WR et al. (1993) Low energy lithotripsy with the Lithostar: treatment results with 19,962 renal and ureteral calculi. J Urol 149: 1419

    CAS  PubMed  Google Scholar 

  14. Bierkens AF, Hendrikx AJ, Berkel HV et al. (1992) Efficacy of second generation lithotriptors: a multicenter comparative study of 2,206 extracorporeal shock wave lithotripsy treatments with the Siemens Lithostar, Dornier HM4, Wolf Piezolith 2300, Direx Tripter X-1, and Breakstone lithotriptors. J Urol 148: 1052

    CAS  PubMed  Google Scholar 

  15. Cass AS (1995) Comparison of first generation (Dornier HM3) and second generation (Medstone STS) lithotriptors: treatment results with 13,864 renal and ureteral calculi. J Urol 153: 588

    Article  CAS  PubMed  Google Scholar 

  16. Park HK, Paick SH, Kim HH et al. (2004) Ureteroscopic lithotripsy under local anesthesia: analysis of the effectiveness and patient tolerability. Eur Urol 45: 670

    Article  PubMed  Google Scholar 

  17. Blute ML, Segura JW, Patterson DE (1988) Ureteroscopy. J Urol 139: 510

    CAS  PubMed  Google Scholar 

  18. Dretler SP, Cho G (1989) Semirigid ureteroscopy: a new genre. J Urol 141: 1314

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hyeon Hoe Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jeong, B.C., Park, H.K., Kwak, C. et al. How painful are shockwave lithotripsy and endoscopic procedures performed at outpatient urology clinics?. Urol Res 33, 291–296 (2005). https://doi.org/10.1007/s00240-005-0474-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-005-0474-6

Keywords

Navigation