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The Effect of Shock Number on Short-Term Complication Development following Extracorporeal Shock Wave Lithotripsy
Journal article   Open access   Peer reviewed

The Effect of Shock Number on Short-Term Complication Development following Extracorporeal Shock Wave Lithotripsy

Miriam Hadj-Moussa, Lifang Zhang and James A Brown
Current urology, Vol.4(2), pp.62-66
05/2010
DOI: 10.1159/000253414
url
https://doi.org/10.1159/000253414View
Published (Version of record) Open Access

Abstract

Objective: To assess whether high shock number is associated with higher rates of short-term complication development following extracorporeal shock wave lithotripsy (ESWL). Patients and Methods: A retrospective chart review was conducted of 224 patients from 1998 to 2008 at a state medical center. Shock number and postoperative complication development were collected for each procedure. All procedures were conducted at 24 kV. Treatments were split into three cohorts based on shock number (≤2,400, 2,401–3,999, and ≥4,000). Postoperative complication development was compared among cohorts. A short-term complication was defined as: pain requiring narcotics, gross hematuria >24 hours, urinary retention, nausea and vomiting, fever, and/ or dysuria within one month of ESWL in a patient without a significant residual stone (≥4 mm). Results: Two hundred and twenty-four patients underwent 294 ESWL procedures. Shock number was unavailable for four treatments. ESWL treatments recorded for the low, medium, and high shock number cohort were 97 (33.4%), 75 (25.9%), and 118 (40.7%), respectively. Overall complication rate was 11.6% (n = 22). Complication rate for each shock number cohort (patients lacking significant residual stone) was 3.2% (n = 6), 4.2% (n = 8), and 4.2% (n = 8), respectively. A chi-squared test showed no statistical difference between shock number cohort and complication development. Complications attributed to a significant residual stone occurred following 45.5% (n = 46) of treatments. Conclusion: At a high voltage, high shock number was not shown to cause higher rates of acute postoperative complications when ESWL was successful. Complication rates associated with a significant residual stone burden were approximately four times as common. Foregoing higher shock number in the presence of a residual stone may therefore increase the risks of sequelae immediately following ESWL.
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