A comparison of stone free rate between a diuretic and a control group of patients undergoing extracorporeal shock wave lithotripsy: a prospective, randomized, double-blind, placebo-controlled trial
Peereapat Cheewaisrakul
Division of Urology, Department of Surgery, Chaophraya Yommarat Hospital, Suphanburi 72000, Thailand; E-mail: pom_uro@yahoo.com
 Objectives: To compare the stone free rate and treatment success rate between a diuretic group of patients undergoing extracorporeal shock wave lithotripsy (ESWL) and a control placebo group (normal saline solution).
Materials and Methods: One hundred and ninety-four patients with solitary renal calculi or ureteric calculi size of 5 mm or over were prospectively randomized into 2 groups. Ninety-seven patients in the first group (diuretic group) underwent ESWL after intravenous injection of furosemide 40 mg, and 97 patients in the second (control) group received normal saline solution 4 ml instead of furosemide prior to ESWL. The treatment protocol included 3,000 shockwaves per patient in each session with the energy beginning at 8 and progressing up to 15 kilovolts. A maximum of 3 ESWL sessions were permitted per patient. The primary outcome was stone free rate, and the secondary outcome was treatment success rate at 3 months after the first ESWL treatment.
Results: The stone free rate was 48.5% compared to 50.5% for diuretic group and control group respectively and the treatment success rate was 81.4% compared to 64.9%. The difference in stone free rate was not statistically significantly different (p = 0.87), however the treatment success was, p = 0.01.
Conclusion: A combination of diuretic therapy followed by ESWL improves the treatment success rate compared with standard ESWL therapy alone.
วารสารยูโร ปี 2564, July-December ปีที่: 42 ฉบับที่ 2 หน้า 138-143
Stone free rate, Diuretic, extracorporeal shock wave lithotripsy