The following is a summary of “Randomized Controlled Trial of Ultrasonic Propulsion–Facilitated Clearance of Residual Kidney Stone Fragments vs Observation,” published in the December 2024 issue of Urology by Sorensen et al.
Ultrasonic propulsion is a novel technique for clearing kidney stone fragments in awake patients.
Researchers conducted a retrospective study to assess if ultrasonic propulsion cleared residual kidney stone fragments.
They conducted a multicenter, prospective, randomized trial with 1:1 single block randomization, enrolling adults with residual fragments ≤5 mm. Relapse, measured by stone growth, urgent visits, or surgery within 5 years, was the primary outcome. Secondary outcomes included fragment passage within 3 weeks and adverse events (AEs) within 90 days. Kaplan-Meier estimated relapse incidence and log-rank tested treatment vs control groups.
The results showed that the trial (May 9, 2015–April 6, 2024) had a median follow-up of 3.0 years (1.8–3.2). The treatment group (n = 40) had a 52% longer time to relapse than controls (n = 42; 1530 ± 92 days vs 1009 ± 118 days; P < .003) with a lower relapse risk (hazard ratio (HR) 0.30, 95% CI 0.13–0.68). Relapse occurred in 8 of 40 vs 21 of 42 participants, and fragment passage within 3 weeks was higher in treatment 24 (63%) than in control 2 (5%). AEs were mild and occurred in 25 treated (63%) vs 17 controls (40%).
They found that ultrasonic propulsion reduced relapse, increased fragment clearance, and posed minimal risk.
Source: auajournals.org/doi/10.1097/JU.0000000000004186
