title: Immediate or delayed SWL in ureteric stones: a prospective and randomized study.
abstract: The objective is to compare immediate and delayed SWL as a treatment for ureter stones between 5 and 20 mm. Patients who applied to the emergency department with single, radio opaque ureteric stone of 5-20 mm size were included in the study. Patients were randomized into immediate and delayed SWL groups. SWL were carried out after pain relief in the delayed group. Maximum of three SWL sessions were applied to the patients with stones of 5 mm or bigger in diameter, leaving at least 3 days interval in-between. Stone-free rate after first session was similar in two groups. When CIRF was also considered as success, the success rate of SWL in the immediate SWL group was higher after first session (p = 0.02). Immediate SWL had a greater success rate in upper ureteric stones (p = 0.019). Overall average time required for elimination of stones was shorter in immediate SWL group than delayed SWL group (p = 0.033). The success rate after first SWL session (including CIRF) was 59 % for patients with chronic pain in the delayed group and 100 % for patients with acute pain in the immediate group. According to the hydronephrosis grade, success rates were 71 and 44.4 % for patients with grade 1 or no hydronephrosis in the immediate SWL group, and for patients with grade 2 or larger hydronephrosis in the delayed SWL group, respectively, after first SWL session. Immediate SWL insures stone-free status in a shorter time in cases with renal colicky pain and ureteral stones, particularly upper ureteral stones.
authors: Urology Department, GATA Haydarpasa Teaching Hospital, Uskudar, Istanbul, 34668, Turkey.
authors: Sami
authors: S
authors: Uguz
authors: Temucin
authors: T
authors: Senkul
authors: Hasan
authors: H
authors: Soydan
authors: Ferhat
authors: F
authors: Ates
authors: Ilker
authors: I
authors: Akyol
authors: Ercan
authors: E
authors: Malkoc
authors: Kadir Vehbi
authors: KV
authors: Baykal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014514:Ureteral Calculi / Q000628:therapy*; D055815:Young Adult