Is Extracorporeal Shock Wave Lithotripsy a Treatment Option for Renal Colic?

• María del Pilar Alcoba García ^[1] ; Gonzalo Bueno Serrano ^[1] ; Juan Tabares Jiménez ^[1] ; Raquel González López ^[1] ; Lidia Coloma Ruíz ^[1] ; Carmen González Enguita ^[1]
  1. [1] Department of Urology, Jiménez Díaz Foundation Hospital, Spain
• Localización: Archivos españoles de urología, ISSN 0004-0614, Tomo 76, Nº. 3, 2023, págs. 175-181
• Idioma: inglés
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• Resumen

  • Background: Renal colic is characterized by sharp, intense flank pain. Nonsteroidal anti-inflammatory drugs are the treatment of choice, although extracorporeal shock wave lithotripsy (SWL) is a noninvasive alternative for pain management. The objective of our study is to present results obtained using rapid SWL to treat renal colic in our center.

    Methods: We analyzed 214 patients undergoing rapid shockwave extracorporeal lithotripsy between October 2014 and June 2018: 69.63% were male, and 30.37% female, with a mean age of 47.35 years (range, 16–84). The average stone size was 6.71 mm (3–16). Stone locations were as follows: The pelviureteric junction (PUJ) (10.75%), proximal ureter (45.79%), midureter (24.77%), and distal ureter (18.69%).

    Results: Pain relief was achieved in 81.31% of the patients. The rates of successful pain control according to stone location were 65.22% when the stone was located in the PUJ, 79.59% in the proximal ureter, 88.68% in the midureter, and 85.00% in the distal ureter. Complete or partial stone resolution was achieved 4 weeks postoperatively in 78.50% of cases (64.95% and 13.55%, respectively). According to the stone location, the overall rate of resolution (complete + partial) was 90.00% for distal ureteral stones, 86.80% in the midureter, 73.47% in the proximal ureter, and 60.86% in the PUJ. 44 patients (20.56%) demonstrated complications. The most common complications were persistent pain, acute renal failure and fever.

    Conclusions: Immediate SWL was found to be a safe and effective treatment option for pain related to renal colic in 81% of the patients studied.