PURPOSE: We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). PATIENTS AND METHODS: A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone International Inc., Aliso Viejo, CA) was conducted. Complications occurred within 4 weeks of SWL. Treatments were split into three cohorts based on shock number (<2400, 2401-4000, and >4000). Postoperative sequelae of patients who were stone free and those with residual stone were studied separately. Chi-square tests were used to evaluate the relationship between shock number cohort and postoperative complication development. RESULTS: SWL treatments recorded for each cohort were 158 (37.4%), 145 (34.4%), and 119 (28.2%), respectively. The short-term complication rate when SWL was successful was 8.3% overall. Complication rate for each cohort was 9.5% (11), 7.8% (5), and 7.2% (7), respectively. When SWL was successful, statistical analysis revealed no significant difference between complication rates and shock number cohort (P=0.63). Complications in patients with a residual stone occurred after 41.4% of treatments and trended upward with shock number cohort, but did not reach statistical significance (P=0.84). CONCLUSIONS: At high voltage, high shock number was not shown to cause higher rates of short-term postoperative complications, as experienced by patients, when SWL was successful or resulted in a residual stone, yet complication rates associated with residual stone burden were approximately five times as common. Forgoing a higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately after SWL.
PURPOSE: We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). PATIENTS AND METHODS: A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone International Inc., Aliso Viejo, CA) was conducted. Complications occurred within 4 weeks of SWL. Treatments were split into three cohorts based on shock number (<2400, 2401-4000, and >4000). Postoperative sequelae of patients who were stone free and those with residual stone were studied separately. Chi-square tests were used to evaluate the relationship between shock number cohort and postoperative complication development. RESULTS: SWL treatments recorded for each cohort were 158 (37.4%), 145 (34.4%), and 119 (28.2%), respectively. The short-term complication rate when SWL was successful was 8.3% overall. Complication rate for each cohort was 9.5% (11), 7.8% (5), and 7.2% (7), respectively. When SWL was successful, statistical analysis revealed no significant difference between complication rates and shock number cohort (P=0.63). Complications in patients with a residual stone occurred after 41.4% of treatments and trended upward with shock number cohort, but did not reach statistical significance (P=0.84). CONCLUSIONS: At high voltage, high shock number was not shown to cause higher rates of short-term postoperative complications, as experienced by patients, when SWL was successful or resulted in a residual stone, yet complication rates associated with residual stone burden were approximately five times as common. Forgoing a higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately after SWL.
Authors: Bret A Connors; Andrew P Evan; Philip M Blomgren; Lynn R Willis; Rajash K Handa; David A Lifshitz; James E Lingeman; Jun Ying Journal: J Endourol Date: 2006-09 Impact factor: 2.942
Authors: Lynn R Willis; Andrew P Evan; Bret A Connors; Youzhi Shao; Philip M Blomgren; J Howard Pratt; Naomi S Fineberg; James E Lingeman Journal: J Endourol Date: 2005 Jan-Feb Impact factor: 2.942
Authors: J Rassweiler; K U Köhrmann; W Back; S Fröhner; M Raab; A Weber; F Kahmann; E Marlinghaus; K P Jünemann; P Alken Journal: World J Urol Date: 1993 Impact factor: 4.226
Authors: M A Jewett; C Bombardier; A G Logan; K E Psihramis; T Wesley-James; J E Mahoney; J J Luymes; D Ibañez; M R Ryan; R J Honey Journal: J Urol Date: 1998-10 Impact factor: 7.450