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Pain in extracorporeal shock wave lithotripsy
James Theo Berwin1, T El-Husseiny, A G Papatsoris
1Endourology and Stone Services, Barts and The London NHS Trust, London, UK. jtberwin@hotmail.com
Urological Research
|February 3, 2009
Summary
Younger, thinner female patients exhibit lower pain tolerance during shock wave lithotripsy (SWL) for kidney stones, impacting treatment success. Understanding these factors aids in predicting patient outcomes for SWL procedures.
Area of Science:
- Urology
- Pain Management
- Nephrolithiasis Treatment
Background:
- Pain tolerance is a known factor affecting shock wave lithotripsy (SWL) success for renal calculi.
- Predicting pain tolerance can optimize SWL treatment protocols.
Purpose of the Study:
- To identify factors directly influencing pain tolerance during SWL.
- To predict patient suitability for successful SWL treatment based on pain tolerance.
Main Methods:
- Retrospective analysis of 179 patients undergoing their first SWL for a solitary kidney stone.
- Patients received non-opioid analgesia on an outpatient basis.
- Comparison of patients tolerating target shock wave parameters versus those requiring reduction.
Main Results:
- 53% of patients tolerated the full 4,000 shock waves at energy level 4.
- Younger, thinner female patients demonstrated significantly lower pain tolerance.
- These demographic factors were identified through univariate and multivariate analysis.
Conclusions:
- Female sex, younger age, and thin body habitus are associated with reduced pain tolerance to SWL.
- These findings can help clinicians anticipate and manage pain during SWL for kidney stones.
- Optimizing SWL treatment based on predicted pain tolerance may improve patient outcomes.
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