title: Rapid extracorporeal shock wave lithotripsy treatment after a first colic episode correlates with accelerated ureteral stone clearance.
abstract: OBJECTIVE
  To investigate the relationship between delay in extracorporeal shock wave lithotripsy (ESWL) after a first colic and subsequent time to complete stone clearance.
  
  
  METHODS
  This prospective, non-randomized study included 94 patients treated with ESWL for unilateral solitary proximal ureteral stones after at least one episode of colic pain. Time between the first onset of colic pain and ESWL and stone clearance was recorded. The pretherapeutic degree of hydronephrosis has been assessed using ultrasound.
  
  
  RESULTS
  Mean stone size was 7.9 +/- 2.3 mm and mean time before ESWL after a first colic was 93.4 +/- 143.5 h. At 3 months, 3 patients were lost to follow-up. In 76.9% of patients stones were completely cleared and a further 3.3% harbored residual fragments < or =3 mm. Delay in treatment after a first colic correlated with subsequent time to stone clearance (p < 0.0001). Mean time to stone clearance in patients treated within 24h was 6.4 +/- 6.3 days compared with 16.0 +/- 17.8 days for those treated later (p = 0.008). Maximum stone diameter correlated with time to stone clearance (p = 0.031), but the degree of hydronephrosis did not.
  
  
  CONCLUSIONS
  Rapid ESWL after a first onset of colic pain resulted in accelerated stone clearance independent of the degree of hydronephrosis but had no impact on the need for auxiliary procedures.
authors.affiliation: Department of Urology, Medical University of Vienna, Austria. drseitz@gmx.at
authors.forename: Christian
authors.initials: C
authors.lastname: Seitz
authors.forename: Harun
authors.initials: H
authors.lastname: Fajković
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.forename: Matthias
authors.initials: M
authors.lastname: Waldert
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozsoy
authors.forename: Gero
authors.initials: G
authors.lastname: Kramer
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003085:Colic / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D013997:Time Factors; D014514:Ureteral Calculi / Q000150:complications* / Q000628:therapy*; D014515:Ureteral Diseases / Q000209:etiology* / Q000628:therapy*