Optimal Timing of Extracorporeal Shock Wave Lithotripsy for Residual Stones After Percutaneous Nephrolithotomy: A Prospective Randomized Study

What this Trial Is About

Researchers are investigating the best timing for extracorporeal shock wave lithotripsy (ESWL) after percutaneous nephrolithotomy (PCNL) in patients with residual kidney stones measuring 15 mm or less. Residual stone fragments after PCNL are common and can lead to recurrent stones, infections, or blockages, often requiring further treatment. This randomized study aims to compare early ESWL (within 7-14 days post-PCNL) versus delayed ESWL (after 3-4 weeks) to find the optimal approach that balances stone clearance and complication risks. Participants are divided into two groups: one receives ESWL treatment early, within 7-14 days after PCNL, and the other receives it later, after 3-4 weeks. Both groups use the same type of lithotripter and follow standardized treatment settings per European Association of Urology guidelines. Up to three ESWL sessions are allowed per patient with sedation or pain relief as needed. The study monitors patients clinically and with imaging to evaluate stone clearance. During the study, patients will undergo imaging tests such as ultrasound or non-contrast CT scans after ESWL to check for remaining stones. The main measure of success is the stone-free rate at 3 months. Secondary measures include rates of complications like bleeding or infection, pain levels, changes in kidney function, and the need for further procedures. Follow-up includes clinical and radiological assessments to guide treatment evaluation and patient safety over the course of the study.

Early vs Delayed Extracorporeal Shock Wave Lithotripsy for Residual Stones After Percutaneous Nephrolithotomy