The optimal treatmnt timing for extracorporeal shock wave lithotripsy in patients with renal colic

Abstract

Objective To seek the optimal treatmnt timing for extracorporeal shock wave lithotripsy(ESWL) in patients with ureteral calculi-induced renal colic. Methods A total of 505 patients with ureteral calculi-induced renal colic were followed and observed, and all patients were divided into three groups according to the time interval from the first colic attack to ESWL, including 123 patients treated by ESWL in the attack of colic or the emergency ESWL(group A), 162 patients treated by ESWL in 3~6 days after pain relief (group B) and 220 patients treated by ESWL after 7 days of pain relief (group C). Success rate of fragmentation in the first time of ESWL, stone-free rate after 2 weeks of operation, pain recurrence rate and percentage of renal infection were evaluated. Results All patients with renal colic in group A were cured, the rate of renal colic relieving was 100%.The success rate of fragmentation , stone-free rate after 2 weeks of operation in the group A and the group B were higher than those in the group C(93.5% vs. 84.6%, 94.4% vs. 84.6%, 87.0% vs. 74.1%, 85.8% vs. 74.1%), the difference was statistically significant, respectively(P 0.05). The pain recurrence rate and percentage of renal infection of the group A were 50.4% and 17.1%, respectively, which were higher than those of the group B(4.9% and 5.6%, respectively, P<0.01) and the group C(6.8% and 5.9%, respectively, P<0.01). Conclusions ESWL should be used earlier in the patients with ureteral calculi-induced renal colic, and the application of it to renal colic at acute stage is effective with high rate of pain relief.The optimal treatmnt ti-ming for ESWL is within 3~6 days after pain relief. Key words: Kidney Calculi; Ureteral Calculi; Lithotripsy