Immediate or delayed SWL in ureteric stones: a prospective and randomized study

Area of Science:

• Urology
• Nephrology
• Medical Technology

Background:

• Ureteric stones pose a significant clinical challenge, necessitating effective treatment strategies.
• Shock wave lithotripsy (SWL) is a common modality for ureter stone management.
• The optimal timing for SWL, immediate versus delayed, requires further investigation for stones sized 5-20 mm.

Purpose of the Study:

• To compare the efficacy of immediate versus delayed SWL for treating ureter stones.
• To evaluate stone-free rates, treatment duration, and success rates based on stone location and patient presentation.

Main Methods:

• A randomized study involving patients with single, radio-opaque ureteric stones (5-20 mm).
• Patients were assigned to either immediate SWL or delayed SWL (after pain relief).
• A maximum of three SWL sessions were administered with at least a 3-day interval for stones ≥5 mm.

Main Results:

• The stone-free rate after the first SWL session was similar between groups.
• Immediate SWL demonstrated a higher overall success rate, particularly for upper ureteric stones (p=0.019).
• The average time for stone elimination was significantly shorter in the immediate SWL group (p=0.033).

Conclusions:

• Immediate SWL is more effective than delayed SWL for ureter stones, especially upper ureteric stones.
• Immediate SWL ensures stone-free status in a shorter time, particularly in cases with acute renal colicky pain.
• The study highlights the benefits of prompt SWL intervention for improved patient outcomes.