Complementary approaches to decreasing discomfort during shockwave lithotripsy (SWL)

Area of Science:

• Urology
• Pain Management
• Complementary Medicine

Background:

• Shock wave lithotripsy (SWL) is a common treatment for renal stones.
• SWL, despite being non-invasive, can cause significant patient pain and anxiety.
• The need for effective pain and anxiety management during SWL is critical.

Purpose of the Study:

• To systematically review the literature on complementary therapies used during SWL.
• To assess the impact of complementary therapies on analgesic and anxiolytic requirements.
• To evaluate the effect of complementary therapies on stone-free rates (SFR).

Main Methods:

• Systematic review of prospective randomized controlled trials.
• Included therapies: acupuncture, auricular acupressure, transcutaneous electrical nerve stimulation (TENS), and music.
• Data extracted on analgesia requirement, anxiety levels, and SFR.

Main Results:

• Seven studies involving 591 patients were analyzed.
• Four studies showed significant improvement in pain control/analgesia requirement (music, acupuncture, TENS).
• Three studies reported significantly lower anxiety with music and acupuncture; no effect on SFR was observed.

Conclusions:

• Complementary therapies can effectively reduce the need for analgesics and anxiolytics during SWL.
• Music and acupuncture appear particularly beneficial for managing pain and anxiety.
• These therapies do not influence the stone-free rates after SWL.