Min Soo Choo1, Jun Hyun Han1, Jong Keun Kim1, Tae Young Shin2, Won Ki Lee2, Sang Kon Lee2, Seong Ho Lee3. 1. Department of Urology, Hallym University Songtan Sacred Heart Hospital, Hwaseong, Korea. 2. Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea. 3. Department of Urology, Hallym University Songtan Sacred Heart Hospital, Hwaseong, Korea. shleeuro@hallym.ac.kr.
Abstract
PURPOSE: We compared the outcomes of SWL to treat distal ureter stones with regard to the conventional prone and supine positions using the transgluteal approach through the greater sciatic foramen. METHODS: A prospective, randomized, single-blind, and multicenter study was conducted between October 2014 and July 2015. The inclusion criteria were radio-opaque distal ureter stones with a maximum diameter of 0.5-2 cm as measured on a CT scan. The included 160 patients were randomly assigned to two groups: the prone group (n = 80; treated in the conventional prone position) and the transgluteal group (n = 80; treated in the supine position using a transgluteal approach). In the latter group, the focused shock wave was transmitted through the greater sciatic foramen with the head positioned at a 40° angle to the vertical. "Stone-free" was defined as the complete clearance of stone fragments, assessed using a CT scan at 2 weeks after treatment. Overall satisfaction was self-reported using a 0-5 Likert scale. RESULTS: The overall efficacy was 66.9%. The stone-free rate was significantly higher in the transgluteal group (72.6%) than in the prone group (54.7%; odds ratio 2.413, 95% CI 1.010-5.761, P = 0.023). No serious adverse events due to treatment were observed in either group. The satisfaction score of the transgluteal group was 4.21 ± 0.81, and 83.6% were willing to repeat the same procedure if necessary. CONCLUSIONS:SWL using the transgluteal approach via a supine position through the greater sciatic foramen was more effective than via the conventional prone position. Furthermore, this approach provided a comparably safe and satisfactory procedure.
RCT Entities:
PURPOSE: We compared the outcomes of SWL to treat distal ureter stones with regard to the conventional prone and supine positions using the transgluteal approach through the greater sciatic foramen. METHODS: A prospective, randomized, single-blind, and multicenter study was conducted between October 2014 and July 2015. The inclusion criteria were radio-opaque distal ureter stones with a maximum diameter of 0.5-2 cm as measured on a CT scan. The included 160 patients were randomly assigned to two groups: the prone group (n = 80; treated in the conventional prone position) and the transgluteal group (n = 80; treated in the supine position using a transgluteal approach). In the latter group, the focused shock wave was transmitted through the greater sciatic foramen with the head positioned at a 40° angle to the vertical. "Stone-free" was defined as the complete clearance of stone fragments, assessed using a CT scan at 2 weeks after treatment. Overall satisfaction was self-reported using a 0-5 Likert scale. RESULTS: The overall efficacy was 66.9%. The stone-free rate was significantly higher in the transgluteal group (72.6%) than in the prone group (54.7%; odds ratio 2.413, 95% CI 1.010-5.761, P = 0.023). No serious adverse events due to treatment were observed in either group. The satisfaction score of the transgluteal group was 4.21 ± 0.81, and 83.6% were willing to repeat the same procedure if necessary. CONCLUSIONS: SWL using the transgluteal approach via a supine position through the greater sciatic foramen was more effective than via the conventional prone position. Furthermore, this approach provided a comparably safe and satisfactory procedure.
Authors: Dean Assimos; Amy Krambeck; Nicole L Miller; Manoj Monga; M Hassan Murad; Caleb P Nelson; Kenneth T Pace; Vernon M Pais; Margaret S Pearle; Glenn M Preminger; Hassan Razvi; Ojas Shah; Brian R Matlaga Journal: J Urol Date: 2016-05-27 Impact factor: 7.450
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Authors: Doo Yong Chung; Kang Su Cho; Dae Hun Lee; Jang Hee Han; Dong Hyuk Kang; Hae Do Jung; Jong Kyou Kown; Won Sik Ham; Young Deuk Choi; Joo Yong Lee Journal: PLoS One Date: 2015-04-22 Impact factor: 3.240