Complications in extracorporeal shockwave lithotripsy: a cohort study

Area of Science:

• Urology
• Nephrology
• Medical Technology

Background:

• Extracorporeal shockwave lithotripsy (ESWL) is a common procedure for kidney stone removal.
• Evaluating post-ESWL complications is crucial for optimizing patient care and treatment protocols.

Purpose of the Study:

• To assess the incidence of clinically relevant complications within 14 days following ESWL in a contemporary clinical setting.
• To identify risk factors associated with ESWL-related complications.

Main Methods:

• Retrospective analysis of consecutive ESWL treatments from 2009-2015 at Ängelholm Hospital, Sweden.
• Primary outcome: patient-reported medical attention within 14 days post-ESWL.
• Multivariable analysis adjusted for diabetes, stone size/location, and urinary stent presence.

Main Results:

• Out of 1838 treated stones, 6.4% (116 cases) required medical attention within 14 days; 4% (75 cases) needed hospital care.
• Infection occurred in 2.4% of cases. Invasive interventions were performed in 2.2%.
• Diabetes, larger stone size (11-30 mm), and need for antiemetics during treatment were linked to increased complication risk. Distal stones had lower complication rates.

Conclusions:

• Modern ESWL treatment is generally safe with a low complication rate.
• Diabetes and larger stone size are significant risk factors for complications.
• Using a 1 Hz frequency may reduce complications; further study on antiemetic use is warranted. Distal stones present a lower risk.