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Inicio Actas Urológicas Españolas (English Edition) Is extracorporeal lithotripsy a first-line treatment for urinary stones today?
Journal Information
Vol. 48. Issue 2.
Pages 134-139 (March 2024)
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Vol. 48. Issue 2.
Pages 134-139 (March 2024)
Original article
Is extracorporeal lithotripsy a first-line treatment for urinary stones today?
Validez actual de la litotricia extracorpórea como tratamiento de primera línea de la litiasis
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C. Minguez Ojeda
Corresponding author
cesar.minguez.1994@gmail.com

Corresponding author.
, I. Laso García, D. López Curtis, G. Duque Ruiz, M. Mata Alcaraz, M. Santiago González, A. Artiles Medina, M. Hevia Palacios, F. Arias Fúnez, F.J. Burgos Revilla
Servicio de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid. Spain
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Tables (5)
Table 1. Baseline characteristics of the patients.
Table 2. Univariate and multivariate analysis of stone size reduction.
Table 3. Factors associated with the need for retreatment.
Table 4. Complications associated to SWL.
Table 5. Risk factors associated with complications after SWL.
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Abstract
Objective

To evaluate the efficacy and complications of extracorporeal lithotripsy (SWL) as a first-line treatment for renal and ureteral stones

Methods

Retrospective and observational study of all the patients treated with lithotripsy in a third level center between January 2014 and January 2021; characteristics of the patients, the stones, complications and results of SWL is recollected. Multivariate logistic regression of the factors associated with stone size reduction was performed. A statistical analysis of the factors associated with additional treatment after SWL and factors associated with complications is also executed.

Results

1727 patients are included. Stone mean size was 9,5mm. 1540 (89.4%) patients presented reduction in stone size. In multivariate analysis, stone size (OR=1.13; p=0.00), ureteral location of the lithiasis (OR=1.15; p=0.052) and number of waves (p=0.002; OR=1.00) used in SWL are the factors associated with reduction of stone size. Additional treatment after lithotripsy was needed in 665 patients (38.5%). The factors associated with the need for retreatment were stone size (OR=1.131; p=0.000), number of waves (OR=1.000; p=0.000), energy (OR=1.005; p=0.000). 153 patients (8.8%) suffered complications after SWL. A statistically significant association was found between the size of the lithiasis (p=0.024, OR=1.054) and the previous urinary diversion (P=0.004, OR=0.571).

Conclusion

Lithotripsy remains an effective treatment as the first line of therapy for reno-ureteral lithiasis with a low percentage of complications.

Keywords:
Stones
Lithotripsy
Treatment
Extracorporeal lithotripsy SWL
Complications
Effective
Resumen
Objetivo

Evaluar la eficacia y complicaciones de la litotricia extracorpórea por ondas de choque (LEOCh) como tratamiento de primera línea de la litiasis renal y ureteral.

Métodos

Estudio observacional retrospectivo de todos los pacientes tratados con litotricia en un centro de tercer nivel entre enero de 2014 y enero de 2021. Se recogieron las características de los pacientes, de la litiasis, y las complicaciones y resultados de la LEOCh. Se realizó una regresión logística multivariante de los factores asociados a la reducción del tamaño litiásico. También se llevó a cabo un análisis estadístico de los factores asociados a la necesidad de tratamiento adicional tras la LEOCh y de los factores asociados a las complicaciones.

Resultados

Se incluyeron 1727 pacientes. El tamaño litiásico medio fue de 9,5mm. En 1540 (89,4%) pacientes se observó la reducción del tamaño litiásico. En el análisis multivariante, el tamaño (OR=1,13; p=0,00), la localización de la litiasis en el uréter (OR=1,15; p=0,052) y el número de ondas (p=0,002; OR=1,00) utilizadas en la LEOCh son los factores asociados a la reducción del tamaño litiásico. Un total de 665 pacientes (38,5%) precisaron tratamiento adicional tras la litotricia. Los factores asociados a la necesidad de retratamiento fueron el tamaño litiásico (OR=1,131; p=0,000), el número de ondas (OR=1,000; p=0,000) y la energía administrada (OR=1,005; p=0,000). En 153 pacientes (8,8%) se produjeron complicaciones tras la LEOCh. Se encontró una asociación estadísticamente significativa entre el tamaño de la litiasis (p=0,024; OR=1,054) y la derivación urinaria previa (p=0,004; OR=0,571).

Conclusión

La litotricia sigue siendo eficaz como tratamiento de primera línea para la litiasis reno-ureteral, con un bajo porcentaje de complicaciones.

Palabras clave:
Litiasis
Litotricia
Tratamiento
Litotricia extracorpórea por ondas de choque (LEOCh)
Complicaciones
Eficaz

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