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Shock-wave lithotripsy: variance within UK practice.

N L Sharma1, C E Alexander2, E Grout3

  • 1Oxford Stone Group, Department of Urology, Nuffield Department of Surgical Sciences, Oxford University Hospitals NHS Trust, Oxford, UK. ntyreman@doctors.org.uk.

Urolithiasis
|May 25, 2016
PubMed
Summary
This summary is machine-generated.

UK shock-wave lithotripsy (SWL) centers show significant variations in treatment protocols, including contraindications and medication management. This disparity highlights the need for national guidelines to standardize care for patients with kidney and ureteric stones.

Keywords:
GuidelinesPracticesShock-wave lithotripsyUK

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Area of Science:

  • Urology
  • Nephrology
  • Medical Technology

Background:

  • Shock-wave lithotripsy (SWL) is a common treatment for kidney and ureteric stones.
  • Standardized treatment protocols are crucial for effective and safe patient care.
  • Current SWL practices in the UK have not been comprehensively evaluated.

Purpose of the Study:

  • To determine the current treatment policies and service delivery of fixed-site SWL centers in the UK.
  • To identify variations in SWL protocols, including contraindications, anticoagulation, and medication use.
  • To highlight areas requiring standardization and further investigation in SWL practice.

Main Methods:

  • An observational, real-life study involving 25 fixed-site lithotripter centers in the UK.
  • Questionnaires were distributed to gather data on SWL protocols and service delivery.
  • Data collected covered anticoagulation management, antibiotic and analgesia use, urine testing, and patient contraindications.

Main Results:

  • Responses were obtained from 21 centers, with most using the Storz Modulith lithotripter.
  • Significant variations were observed in clinical contraindications (e.g., abdominal aortic aneurysms, pacemakers) and anticoagulation management.
  • Diverse analgesia regimens, inconsistent use of prophylactic antibiotics, and varied tamsulosin prescription practices were reported.

Conclusions:

  • This study reveals substantial disparities in SWL delivery across UK centers.
  • Key areas of controversy include patient selection, anticoagulation, and pharmacotherapy.
  • Development of national guidelines is recommended to ensure standardized, high-quality SWL care.