The effects of pretreatment oral hydration on extracorporeal shockwave lithotripsy outcomes

A randomized controlled trial

Authors

DOI:

https://doi.org/10.5489/cuaj.8877

Keywords:

extracorporeal shock wave lithotripsy, oral hydration, stone-free rate, urolithiasis

Abstract

INTRODUCTION: We sought to investigate the effects of pretreatment oral hydration on the outcomes of extracorporeal shockwave lithotripsy (ESWL).

METHODS: Patients who underwent ESWL for a single, radio-opaque, renal or proximal ureteric calculus ≤2 cm in size were randomized into two groups. The oral hydration group (OHG) was administered 600 ml of water before ESWL, while the control group (CG) was not. The urine was held during ESWL to create a full bladder-induced hydronephrosis. Both groups received the same ESWL protocol at four-week intervals and a maximum of three sessions. The primary outcome was stone-free rate (SFR) at 12 weeks and the secondary outcomes were the total number of shockwaves and the number of ESWL sessions.

RESULTS: A total of 154 patients completed the study — 77 patients in each group; both groups were comparable in demographic data and stone characteristics. The SFR was 84.4% in the OHG and 68.8% in the CG group (p=0.036). Stone fragmentation in the OHG was significantly higher than in the CG at 75.3% vs. 58.4% (p=0.040). The OHG had more cases of artificial hydronephrosis (55.8% vs. 27.3%, p=0.001) and higher urine volume (375 [148] ml vs. 230 [110] ml, p<0.001). There were no statistically significant differences in the total number of shockwaves and the number of ESWL sessions. The auxiliary procedures in the OHG were less than in the CG (15.6% vs. 31.2%, p=0.049).

CONCLUSIONS: Pretreatment oral hydration, together with holding urine during ESWL, has increased stone disintegration and SFR. This simple and safe technique improves the ESWL outcomes.

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Published

2024-11-04

How to Cite

Prasanchaimontri, P., & Somboon, P. . (2024). The effects of pretreatment oral hydration on extracorporeal shockwave lithotripsy outcomes: A randomized controlled trial. Canadian Urological Association Journal, 19(3), E98–103. https://doi.org/10.5489/cuaj.8877

Issue

Vol. 19 No. 3 (2025): CUAJ March

Section

Original Research

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