Repeat Stone Treatment More Likely After SWL

The re-intervention rate was 11% for patients treated with SWL.
The re-intervention rate was 11% for patients treated with SWL.

ORLANDO—Kidney stone patients treated with shock wave lithotripsy (SWL) are significantly more likely to have repeat interventions compared with those treated with uretroscopy, researchers reported at the American Urological Association 2014 annual meeting.

In a retrospective cohort, Charles Scales, MD, MSHS, of Duke University School of Medicine in Durham, N.C., and collaborators studied privately-insured beneficiaries who went to an emergency department for kidney stone removal from 2002 to 2010. All patients were treated with either SWL or ureteroscopy.

“Advances in ureteroscopy, along with emerging evidence of reduced efficacy of modern lithotripters, has created uncertainty regarding the comparative effectiveness of these two treatment options,” the authors noted in their study abstract.

In total, 27,031 patients underwent SWL and 31,738 underwent uretroscopy. About 21.3% of patients had to undergo an additional procedure to further remove stones: 6,029 in the ureteroscopy group and 6,464 in the SWL.

In adjusted analyses, researchers found that the likelihood of repeat intervention was 11% with SWL versus 0.2% with ureteroscopy.

“Among privately-insured beneficiaries requiring procedural intervention to remove a symptomatic stone, repeat intervention is substantially more likely following SWL,” they concluded.

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