Related Experiment Video
Updated: Aug 27, 2025
03:56
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
2.5K
Modified shockwave propulsion lithotripsy improves the lower pole renal stone clearance
Arthur Grabsky1,2, Karen Arzumanyan1, Gor Shadyan1,2
1Department of Urology, Yerevan State Medical University named after M. Heratsi, Yerevan, Armenia.
Urolithiasis
|September 26, 2022
Summary
A new shockwave propulsion lithotripsy (SWPL) technique significantly improved stone-free rates for lower pole kidney stones compared to standard shockwave lithotripsy (SWL). SWPL also required fewer shockwaves, offering a more effective treatment option.
Area of Science:
- Urology
- Nephrology
- Medical Devices
Background:
- Shockwave lithotripsy (SWL) is a standard treatment for urinary stones.
- Lower pole renal stones present unique treatment challenges due to gravity and anatomy.
Purpose of the Study:
- To introduce and evaluate a modified technique, shockwave propulsion lithotripsy (SWPL).
- To compare the clinical outcomes of SWPL versus standard SWL for lower pole stones.
Main Methods:
- A prospective study of 168 patients with lower pole stones (up to 2 cm).
- Patients were divided into two groups: ultrasound-guided SWL (n=80) and SWPL (n=88).
- Data collected from January 2016 to December 2021.
Main Results:
- SWPL demonstrated a significantly higher stone-free rate (SFR) than standard SWL (85.2% vs. 62.5%, p=0.001).
- SWPL required fewer applied shockwaves (2151 vs. 2502, p=0.001).
- Complication rates were similar between groups (7.1% overall), with most patients needing only one session.
Conclusions:
- The proposed SWPL technique effectively addresses challenges of treating lower pole stones.
- SWPL increases stone-free rates and reduces the need for repeat treatments.
- SWPL offers a promising advancement in managing lower pole renal calculi.
Keywords:
Lower pole renal stonesShockwave lithotripsyShockwave propulsionUltrasound-guided lithotripsyUrolithiasisMore Related Videos
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
21
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
21
01:30Urinary Tract Calculi III: Medical Management
17
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
17
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
23
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
23
01:28Urinary Tract Calculi V: Nursing Management
24
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
24
01:24Imaging Studies II: Ultrasonography
43
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
43
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
35
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
35