Document Detail


Randomized controlled study of mechanical percussion, diuresis, and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy.
MedLine Citation:
PMID:  15922429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether mechanical percussion, diuresis, and inversion (PDI) therapy after shock wave lithotripsy (SWL) improves the clearance rates of lower pole renal stones. METHODS: In this single-blind study, 108 patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. One group (n = 49) received SWL only and the other group (n = 59) received a median of four sessions of PDI therapy (range 1 to 12), 1 to 2 weeks after each SWL session. PDI therapy was performed as follows. Patients drank 500 mL of water 30 minutes before therapy; they then lay in a prone Trendelenburg position on a 45 degrees -angle couch, and received continuous 10-minute manual mechanical percussion applied over the flank. Stone clearance was documented with plain abdominal radiography, with additional imaging, if indicated, 1 and 3 months after initial SWL therapy. RESULTS: The patients from both groups were comparable in terms of total stone diameter, infundibular neck diameter, infundibular length, caliceal height, infundibular-pelvic angles, infundibular-ureteral angles, infundibular-vertebral angles, lower pole cortical thickness, and caliceal number. All patients underwent a maximum of four SWL treatments. For all assessable patients, the radiologically documented complete stone clearance rate at 3 months for the SWL-alone group was 35.4% and for the SWL plus PDI group was 62.5% (chi-square test, P = 0.006). CONCLUSIONS: PDI therapy is a valuable adjunct in assisting passage of lower pole renal stone fragments after SWL therapy.
Authors:
Edmund Chiong; Sandra Tay Poh Hwee; Li Man Kay; Shen Liang; Revathi Kamaraj; Kesavan Esuvaranathan
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Urology     Volume:  65     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-14     Completed Date:  2005-12-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1070-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, National University of Singapore, Singapore. surce@nus.edu.sg
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Diuresis*
Female
Humans
Kidney Calculi / pathology,  therapy*
Kidney Calices / pathology
Lithotripsy*
Male
Middle Aged
Percussion
Physical Therapy Modalities*
Posture
Single-Blind Method

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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