To evaluate the efficacy and safety of performing extracorporeal physical vibrational lithecbole (EPVL) through greater sciatic foramen (GSF) for distal ureteral calculi (DUC) treatment.
Materials and Methods:
All patients with a diagnosis of DUC (6–10 mm in diameter) were enrolled in this study from October 2018 to May 2020. Patients were randomly divided into three groups receiving EPVL through GSF (Group A, n = 58), or abdominal (Group B, n = 60), or combined with oral use of tamsulosin at 0.4 mg daily (Group C, n = 63).
Results:
There was no significant difference observed in terms of demographic characteristics or size of stones among the three groups (p > 0.05). Compared with the Groups B and C, patients of the Group A displayed a significantly higher score of comfort, with a significantly decreased number of renal colic attacks or analgesics required (p < 0.01). The stone-free rate also significantly increased after 1 and 2 weeks of treatment (p < 0.01), despite such a significant difference among these groups vanishing after 4 weeks of treatment.
Conclusion:
EPVL in the prone position uses the GSF as the path and is a safe and effective approach to treat the distal ureteral calculi.
Get full access to this article
View all access options for this article.
References
1.
ErturhanS, ErbagciA, YagciF, CelikM, SolakhanM, SaricaK. Comparative evaluation of efficacy of use of tamsulosin and/or tolterodine for medical treatment of distal ureteral stones. Urology, 2007; 69:633–636.
2.
ChewcharatA, CurhanG. Trends in the prevalence of kidney stones in the United States from 2007 to 2016. Urolithiasis, 2021; 49:27–39.
3.
LiuG, ChengY, WuW, JiaX, HuJ, XieG, ChenX. Treatment of distal ureteral calculi using extracorporeal physical vibrational lithecbole combined with tamsulosin: A new option to speed up obstruction relief. J Endourol, 2018; 32:161–167.
4.
DellabellaM, MilaneseG, MuzzonigroG. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol, 2005; 174:167–172.
5.
TürkC, NeisiusA, PetrikA, SeitzC, SkolarikosA, ThomasK. EAU guidelines on urolithiasis. Arnhem, The Netherlands: European Association of Urology, 2020.
6.
LuJ, SunX, HeL. Sciaticum majus foramen and sciaticum minus foramen as the path of SWL in the supine position to treat distal ureteral stone. Urol Res, 2010; 38:417–420.
7.
PickardR, StarrK, MaclennanG, et al.Medical expulsive therapy in adults with ureteric colic: A multicentre, randomised, placebo-controlled trial. Lancet, 2015; 386:341–349.
8.
HollingsworthJM, RogersMA, KaufmanSR, BradfordTJ, SaintS, WeiJT, HollenbeckBK. Medical therapy to facilitate urinary stone passage: A meta-analysis. Lancet, 2006; 368:1171–1179.
9.
SeitzC, LiatsikosE, PorpigliaF, TiseliusH-G, ZwergelU. Medical therapy to facilitate the passage of stones: What is the evidence?. Eur Urol, 2009; 56:455–471.
10.
HoneyRJDA, LuymesJ, WeirMJ, KodamaR, TariqN. Mechanical percussion inversion can result in relocation of lower pole stone fragments after shock wave lithotripsy. Urology, 2000; 55:204–206.
11.
PaceKT, TariqN, DyerSJ, WeirMJ, D'A HoneyRJ. Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: A prospective, single blind, randomized controlled trial. J Urol, 2001; 166:2065–2071.
12.
ChiongE, TaySPH, LiMK, ShenL, KamarajR, EsuvaranathanK. Randomized controlled study of mechanical percussion, diuresis, and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy. Urology, 2005; 65:1070–1074.
13.
AlbanisS, AtherH, PapatsorisA, MasoodJ, StaiosD, SheikhT, AkhtarS, BuchholzN. Inversion, hydration and diuresis during extracorporeal shock wave lithotripsy: Does it improve the stone-free rate for lower pole stone clearance?. Urol Int, 2009; 83:211–216.
14.
LongQ, ZhangJ, XuZ, ZhuY, LiuL, WangH, GuoJ, WangG. A prospective randomized controlled trial of the efficacy of external physical vibration lithecbole after extracorporeal shock wave lithotripsy for a lower pole renal stone less than 2 cm. J Urol, 2016; 195:965–970.
15.
WuW, YangZ, XuC, et al.External physical vibration lithecbole promotes the clearance of upper urinary stones after retrograde intrarenal surgery: A prospective, multicenter, randomized controlled trial. J Urol, 2017; 197:1289–1295.
16.
WuW, YangZ, TangF, et al.How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for <15 mm upper urinary stones: A prospective multi-center randomized controlled trial about external physical vibration lithecbole (EPVL). World J Urol, 2018; 36:293–298.
17.
TaoRZ, TangQL, ZhouS, JiaCP, LvJL. External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0–2.0 cm after extracorporeal shock wave lithotripsy: A prospective randomized trial. Urolithiasis, 2020; 48:71–77.
18.
ZhangY, XuC, WangY, et al.When is the best time to perform external physical vibration lithecbole (EPVL) after retrograde intrarenal surgery (RIRS): A multi-center study based on randomized controlled trials. Urolithiasis, 2020; 48:533–539.
19.
JingS, LiuB, LanW, et al.Modified mechanical percussion for upper urinary tract stone fragments after extracorporeal shock wave lithotripsy: A prospective multicenter randomized controlled trial. Urology, 2018; 116:47–54.
20.
LandauEH, PodeD, LencovskyZ, KatzG, MeretykS, ShapiroA. Extracorporeal shock-wave lithotripsy (ESWL) monotherapy for stones in lower ureter. Urology, 1992; 40:132–136.
21.
AhlawatRK, BhandariM, KumarA, KapoorR. Treatment of ureteral calculi with extracorporeal shock wave lithotripsy using the Lithostar device. J Urol, 1991; 146:737–741.
22.
AmielJ, TouabiK, PeyrottesA, ToubolJ.Extracorporeal piezoelectric lithotripsy in the treatment of calculi of the ureter. Apropos of a series of 143 cases. Paper presented at: Annales d'urologie, 1990. https://europepmc.org/article/med/2350164. 2021-06-22.
23.
LuJ, SunX, HeL. Sciaticum majus foramen and sciaticum minus foramen as the path of SWL in the supine position to treat distal ureteral stone. Urol Res, 2010; 38:417–420.
NowfarS, Palazzi-ChurasK, ChangDC, SurRL. The relationship of obesity and gender prevalence changes in United States inpatient nephrolithiasis. Urology, 2011; 78:1029–1033.
26.
ChungDY, ChoKS, LeeDH, et al.Impact of colic pain as a significant factor for predicting the stone free rate of one-session shock wave lithotripsy for treating ureter stones: A Bayesian logistic regression model analysis. PLoS One, 2015; 10:e0123800.
27.
ChooMS, HanJH, KimJK, ShinTY, LeeWK, LeeSK, LeeSH. The transgluteal approach to shockwave lithotripsy to treat distal ureter stones: A prospective, randomized, and multicenter study. World J Urol, 2018; 36:1299–1306.
