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ESWL on Disintegration of Renal Stones

Conditions
Renal Stone
Interventions
Radiation: ESWL
Registration Number
NCT03939325
Lead Sponsor
Assiut University
Brief Summary

The impact of different frequencies on pattern of disintegration of renal stones

Detailed Description

* Prior to the introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980, the only treatment available for calculi that could not pass through the urinary tract was open surgery. Since then, ESWL has become the preferred tool in the urologist's armamentarium for the treatment of renal stones, , ESWL is minimally invasive, exposes patients to less anaesthesia, and yields equivalent stone-free rates in appropriately selected patients.

* The efficacy of ESWL lies in its ability to pulverize calculi in vivo into smaller fragments, which the body can then expulse spontaneously. Shockwaves are generated and then focused onto a point within the body. The shockwaves propagate through the body with negligible dissipation of energy (and therefore damage) owing to the minimal difference in density of the soft tissues. At the stone-fluid interface, the relatively large difference in density, coupled with the concentration of multiple shockwaves in a small area, produces a large dissipation of energy. Via various mechanisms, this energy is then able to overcome the tensile strength of the calculi, leading to fragmentation. Repetition of this process eventually leads to pulverization of the calculi into small fragments that the body can pass spontaneously and painlessly.

* It is well recognized that the popularity of extracorporeal shock wave lithotripsy (SWL), despite its non-invasive character, has decreased during recent years. This is partly explained by the technological achievements in endoscopy and urologists' enthusiasm for such procedures. Another explanation is that many urologists have been insufficiently successful with SWL. The latter effect might to some extent be a result of the performance of the lithotripter used, but in too many cases, it is evident that the principles of how shock wave lithotripsy should be carried out are poorly appliedical aspect

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Pelvic and upper ureteric stones
  • Stone size less than 2 cm
  • Stone density up to 1000 HU
Exclusion Criteria
  • Lower calycle stone
  • Stone size 2 cm or more
  • Stone denstiy more than 1000
  • age group less than 18 y
  • uncontrolled hypertension patient and bleeding disorder
  • Pregnancy
  • Patients with UPJ obstruction, ureteral strictures,
  • Congenital anomalies
  • Previous stented ureter
  • Narrow neck of the calycx less than 30 %

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
second groupESWLpatient who exposed to frequency 80 shock wave per min
third groupESWLpatient who exposed to frequency 100 shock wave per min
first groupESWLpatient who exposed to frequency 60 shock wave per min
Primary Outcome Measures
NameTimeMethod
stone free rate2 weeks

complete disintegration of renal stones or having clinically insignificant gravel smaller than 2 mm

Secondary Outcome Measures
NameTimeMethod
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