Comparison of 2 different fluoroscopy activation intervals in shock wave lithotripsy: a prospective randomized study

TL;DR

A study compared two fluoroscopy intervals during kidney stone treatment and found that longer intervals reduce radiation exposure without affecting treatment success.

Contribution

The study identifies that extending fluoroscopy activation intervals during shock wave lithotripsy reduces radiation exposure without compromising outcomes.

Findings

Fluoroscopy time was significantly longer in the group with more frequent checks.

No significant difference in stone-free status was observed between the two groups.

Extending fluoroscopy intervals reduces radiation exposure without affecting treatment success.

Abstract

Intermittent fluoroscopic controls are required during shock wave lithotripsy (SWL) to readjust the probe due to patients’ movements, respiratory movement, and stone displacement within the kidney. However, there is still no consensus in the literature on the optimal frequency of fluoroscopic monitoring.

Our aim was to determine the optimal fluoroscopy activation interval in fluoroscopy‑guided SWL and examine its effect on fluoroscopy time and stone‑free status.

This prospective randomized study included patients with opaque renal pelvic stones smaller than 2 cm, subjected to fluoroscopy‑guided SWL between July 2020 and January 2024. The patients were divided into 2 groups. Fluoroscopic control was performed every 250 shocks in group 1, and every 500 shocks in group 2. Demographic data, calculus volume and density, skin‑to‑stone distance, number of shots and sessions, fluoroscopy duration, and stone‑free status were analyzed.

The data of 158 randomly included patients (equally divided between both groups) were analyzed. No differences were observed between the groups in terms of demographic data and stone parameters. However, there was a difference in fluoroscopy time, which was longer in group 1 than in group 2 (mean [SD], 217.9 [90.2] vs 117 [37] s, respectively; P <0.001). No differences in stone‑free status between the groups were observed (group 1; 64.5%; group 2, 67%; P = 0.87).

Reducing fluoroscopy activation interval in SWL does not affect stone‑free status, but it helps limit radiation exposure.

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