A new pilot project described in The Journal of Urology suggests that a new approach that combines two ultrasound technologies could be used to move kidney stones out of the ureter with little pain and no anesthesia.
In order to target the stone during the treatment, the doctor employs a portable transducer that is applied to the skin.
The stones can then be moved and repositioned to facilitate passage using an ultrasound procedure called ultrasound propulsion, or they can be broken up using a procedure known as burst wave lithotripsy (BWL).
Lead author Dr. M. Kennedy Hall, an emergency medicine physician at UW Medicine, claimed that new technology doesn’t hurt unlike shock wave lithotripsy, which is currently the usual practice and needs sedation.
“It’s nearly painless, and you can do it while the patient is awake, and without sedation, which is critical.”
According to Hall, the study team anticipates using this new technology to someday move or break up the stones in a clinic or emergency care setting.
Stones in the ureter, which connect the kidney to the bladder, can be extremely painful and are a common complication of trips to the emergency room.
Most ureteral stone patients are instructed to wait to see whether the stone will pass naturally. According to Hall, this monitoring period can persist for several weeks, and approximately one-fourth of patients eventually need surgery.
Every eleventh American will develop a urinary stone at some point in their life. According to one UW Medicine study using the same technologies, the incidence seems to be rising.
According to the study, up to 50% of stone event patients will experience a recurrence within five years.
Hall and his colleagues looked at a new method to find a way to get rid of kidney stones without surgery.
According to Hall, the study was created to examine the viability of breaking up stones in awake, non-anesthetic patients using either BWL or ultrasonic propulsion.
29 patients took part in the investigation. Thirteen patients had propulsion and burst wave lithotripsy, and sixteen patients received propulsion alone.
Stones moved in 19 of the people. In two instances, the stones entered the bladder from the ureter.
In seven of the cases, the stones were shattered by burst wave lithotripsy. 18 of 21 patients (86%) who had stones that were lower in the ureter, nearer the bladder, had passed them at the two-week checkup. The study found that for this group, the average time to stone transit was roughly four days.
According to the study, one of these individuals experienced “immediate relief” when the stone was removed from the ureter.
The researchers’ next step will be to conduct a clinical experiment with a control group that won’t receive either BWL bursts or ultrasound propulsion to assess how much this new technology may help stones pass, according to Hall.
Five years ago, NASA started working on this technology by paying for a study to see if kidney stones could be moved or broken up without anesthesia on long space flights, like the Mars missions. The technology has been so effective that NASA no longer considers kidney stones a major worry.
“We now have a potential solution for that problem,” Hall added.
Patients at Harborview Medical Center, the University of Washington Medical Center-Montlake, and the Northwest Kidney Stone Center at the University of Washington Medical Center-Northwest participated in this study, which started in 2018.
It involved the radiology, urology, and emergency medicine departments of the University of Washington School of Medicine as well as the UW Applied Physics Laboratory.
In other UW Medicine tests, kidney stones were broken up inside the kidneys.
According to Hall, this is the first trial to examine the effects of BWL on moving or dissolving stones in the ureter.
Source: 10.1097/JU.0000000000002864
Image Credit: Getty
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