Baba Dursun, Ekici Necati, Taşkıran Arda Taşkın, Şenoğlu Yusuf, Yüksel Alpaslan, Başaran Ekrem, Özel Mehmet Ali, Balık Ahmet Yıldırım
Department of Urology, Duzce University School of Medicine, Duzce, 81100, Turkey.
Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
BMC Urol. 2025 Feb 20;25(1):35. doi: 10.1186/s12894-025-01716-8.
Urinary stone disease is a common urological disorder, particularly among middle-aged individuals. Extracorporeal Shock Wave Lithotripsy (ESWL) is often the first-line treatment for kidney and ureteral stones. Traditionally, fluoroscopy is used for stone targeting in ESWL, but it exposes patients and clinicians to radiation and cannot visualize non-opaque stones. Ultrasonographic targeting eliminates these issues. This study compares the advantages and disadvantages of fluoroscopy and ultrasound-targeted ESWL.
At Düzce University Hospital, 100 patients with radio-opaque stones indicated for ESWL between February 2023 and February 2024 were divided into two groups. Group A underwent ESWL with fluoroscopic targeting, while Group B used ultrasonographic targeting. Patient demographics, stone size (measured by CT), and stone locations were recorded. The number of shocks per session, energy intensity (kV), and fluoroscopy time were noted for Group A. One week after each ESWL session, patients were evaluated by ultrasound or direct radiography. Success was defined as being stone-free or having ≤ 4 mm asymptomatic residual stones after up to four sessions. Failure was defined as no results after two sessions or the need for additional treatment.
The procedure success rate was 66% for men and 78% for women, with no statistically significant gender difference (p > 0.05). Stone locations were similar in both groups. Success rates were 66% in Group A and 74% in Group B, with no significant difference (p > 0.05). Successful procedures were associated with an average patient weight of 76.6 kg, stone size of 8.9 mm, and total energy of 12.2 kV, with significant differences compared to unsuccessful procedures (p < 0.04, p < 0.04, p < 0.001, respectively). No significant differences were found between Group A and Group B in terms of age, height, BMI, stone density (HU), and number of sessions (p > 0.05).
Ultrasonography is as effective as fluoroscopy for imaging and focusing during ESWL treatment. It enhances the success of ESWL for non-opaque stones and reduces radiation exposure disadvantages.
尿石症是一种常见的泌尿系统疾病，在中年人群中尤为常见。体外冲击波碎石术（ESWL）通常是治疗肾和输尿管结石的一线治疗方法。传统上，在ESWL中使用荧光透视进行结石定位，但这会使患者和临床医生暴露于辐射中，并且无法可视化不透射线的结石。超声定位消除了这些问题。本研究比较了荧光透视和超声定位ESWL的优缺点。
在杜兹大学医院，将2023年2月至2024年2月期间100例适合ESWL治疗的不透射线结石患者分为两组。A组采用荧光透视定位进行ESWL，而B组采用超声定位。记录患者的人口统计学资料、结石大小（通过CT测量）和结石位置。记录A组每次治疗的冲击次数、能量强度（kV）和荧光透视时间。每次ESWL治疗一周后，通过超声或直接放射成像对患者进行评估。成功定义为在最多四次治疗后结石清除或残留无症状结石≤4mm。失败定义为两次治疗后无效果或需要额外治疗。
男性手术成功率为66%，女性为78%，性别差异无统计学意义（p>0.05）。两组结石位置相似。A组成功率为66%，B组为74%，差异无统计学意义（p>0.05）。成功的手术与患者平均体重76.6kg、结石大小8.9mm和总能量12.2kV相关，与不成功的手术相比有显著差异（分别为p<0.04、p<0.04、p<0.001）。A组和B组在年龄、身高、BMI、结石密度（HU）和治疗次数方面无显著差异（p>0.05）。
在ESWL治疗期间，超声在成像和聚焦方面与荧光透视一样有效。它提高了ESWL对不透射线结石的成功率，并减少了辐射暴露的缺点。
