📃 Paper Title: Preliminary results of a randomized controlled trial of prophylactic shock wave lithotripsy for small asymptomatic renal calyceal stones
🧍 Author: Keeley
🕒 Year: 2001
📚 Journal: British Journal of Urology International (BJUI)
🌎 Country: United Kingdom
ㅤContext to the study:
Can you cite a study investigating the role of prophylactic extracorporeal shockwave lithotripsy (ESWL) for the management of small asymptomatic calyceal stones?
ㅤ✅ Take-home message of study:
Prophylactic shock wave lithotripsy (ESWL) for small asymptomatic stones offers little advantage compared to observation in terms of stone-free rates or need for further treatment.
ㅤ Randomised controlled trial
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Study participants:
Participants:
Small asymptomatic renal stones
Specific inclusion criteria:
Asymptomatic or minimally symptomatic (Those with loin pain requiring strong analgesia or dull ache at least once per week were excluded)
Single or multiple stones in calyces
Combined diameter ≤15mm in a single kidney
Patients were randomized into ESWL or observation/control groups. In all 200 patients (101 in ESWL; 99 in observation group) completed at least one annual follow-up and were included in final analysis.
Intervention and Comparison:
Intervention: Shock wave lithotripsy (n=113)
Where no response to treatment, maximum number of sessions was three
Comparison: Observation (n=115)
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Key study outcomes:
Stone free rate at 2-year follow-up: SWL = 28%; Observation = 17% (adjusted p=0.29)
Requirement for additional treatment (SWL, ureteroscopy, ureteric stent insertion, analgesia, antibiotics) at 2-year follow-up: SWL = 15%; Observation = 21% (adjusted p=0.25)
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Study Limitations:
12% of participants were lost to follow-up
Xray KUB (plain film) was used as the primary diagnostic imaging modality
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