Clinical Study On The Treatment Of Distal Ureteral Calculi With External Physical Vibration Lithecbole Through The Greater Sciatic Foramen

Objective: To explore the efficacy and safety of external physical vibration lithecbole(EPVL)through the greater sciatic foramen in the treatment of distal ureteral calculi about 5-10 mm in diameter.Materials and methods: All patients with a diagnosis of distal ureteral calculi(5 – 10 mm in diameter)in the Affiliated Jiangning Hospital of Nanjing Medical University were selected in this study from February 2020 to February 2021.Group A was the study group,received EPVL through the greater sciatic foramen;Group B,control group 1,received EPVL through the abdomen;Group C,control group 2,received tamsulosin.After the three groups of treatment,observe urine color and urine volume,and pay attention to the collection of stone specimens and symptomatic treatment.Postoperative evaluation mainly includes KUB and B-ultrasound examinations.Some patients had CT examinations to be evaluated whether there are residual stones and hydronephrosis.The stone-free rate and related complications were recorded after the treatment.Results: A total of 106 patients were included in study.The sizes of the stones in the three groups were 7.2±1.4mm,7.4±1.5mm,7.3±1.35 mm mm,respectively(P>0.05).The stone expulsion rate of 2 hours after treatment in three groups were 16.2%(6/37),2.9%(1/34),and 0%,respectively(P=0.013).The stone expulsion rate of 24 hours after treatment were 32.4%(12/37)and 8.8%(3/34),2.9%(1/35)(P=0.001).The stone-free rate on week 1 was 64.9%(24/37),38.2%(13/34),37.1%(13/35),and on week 2 was89.2%(33/ 37),58.8%(20/34),60.0%(21/35),all statistically different(P<0.05).There was no significantly difference in stone-free rate on week 4 between three groups(P>0.05).There was no statistically significant difference in dizziness,headache,fatigue,and hematuria between the three groups of patients after receiving treatment.Conclusion: EPVL through the greater sciatic foramen is safe and effective in the treatment of distal ureteral calculi about 5-10 mm.In particular,compared with tamsulosin,it can shorten the stone discharge time,reduce the degree of renal colic.