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Shockwaves Better Than Surgery to Treat Small Kidney Stones
Surgeons from the Department of Urology at University Federico II, Naples, Italy, believe that extracorporeal shockwave lithotripsy (ESWL) - which uses a non-invasive acoustic pulse to break down ureteric stones - should be the treatment of first choice in patients with a stone of up to 1cm. Patients with a stone over 1cm should be treated using uretoscopy (URS), where a ureteroscope is passed into the distal ureter to remove the stone.
"ESWL and URS are both accepted treatments for distal ureteric stones, but there is a lot of discussion about which surgical technique should be used as a first-line strategy for this condition" explains co-author Professor Vincenzo Mirone.
"Approximately one in three adults with kidney stones will have a distal ureteric stone at some point in their lives. Most stones with a diameter of up to 0.5cm will be expelled spontaneously when the patient urinates without requiring any active intervention. For larger stones that get stuck in the ureter, spontaneous expulsion is very difficult and requires active intervention."
The Italian team studied 273 patients with single distal ureteric stones ranging from 0.5cm to 1.5cm, in what they believe is the first prospective randomised study comparing ESWL using an electromagnetic lithotripter and URS.
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