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Effect of High Shock Number on Acute Complication Development After Extracorporeal Shockwave Lithotripsy
Journal article   Open access   Peer reviewed

Effect of High Shock Number on Acute Complication Development After Extracorporeal Shockwave Lithotripsy

Miriam Hadj-Moussa and James A Brown
Journal of endourology, Vol.27(8), pp.115-1019
08/01/2013
DOI: 10.1089/end.2013.0025
PMCID: PMC3852342
PMID: 23537270
url
https://doi.org/10.1089/end.2013.0025View
Published (Version of record) Open Access

Abstract

Purpose: We assessed whether high shock number is associated with higher rates of acute complication development after extracorporeal shockwave lithotripsy (SWL). Patients and Methods: A retrospective chart review of 372 patients who underwent 436 SWL procedures at 24 kV using a Medstone STS-T lithotripter (Medstone International Inc., Aliso Viejo, CA) was conducted. Complications occurred within 4 weeks of SWL. Treatments were split into three cohorts based on shock number (<2400, 2401–4000, and >4000). Postoperative sequelae of patients who were stone free and those with residual stone were studied separately. Chi-square tests were used to evaluate the relationship between shock number cohort and postoperative complication development. Results: SWL treatments recorded for each cohort were 158 (37.4%), 145 (34.4%), and 119 (28.2%), respectively. The short-term complication rate when SWL was successful was 8.3% overall. Complication rate for each cohort was 9.5% (11), 7.8% (5), and 7.2% (7), respectively. When SWL was successful, statistical analysis revealed no significant difference between complication rates and shock number cohort ( P =0.63). Complications in patients with a residual stone occurred after 41.4% of treatments and trended upward with shock number cohort, but did not reach statistical significance ( P =0.84). Conclusions: At high voltage, high shock number was not shown to cause higher rates of short-term postoperative complications, as experienced by patients, when SWL was successful or resulted in a residual stone, yet complication rates associated with residual stone burden were approximately five times as common. Forgoing a higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately after SWL.
Extracorporeal Shockwave Lithotripsy

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