Complementary therapies to shock wave lithotripsy can help lower analgesia requirements and anxiety, "Beyond the Abstract," by B. K. Somani

BERKELEY, CA ( - Shock wave lithotripsy (SWL) is a standard treatment in cases of ureteric or renal calculi. To improve fragmentation rates, any attempt to decrease discomfort and further optimise the power levels used in SWL should be welcomed. Overall, improving SWL analgesia and patient experience could have benefits to lithotripsy application, compliance with further therapy sessions, and pharmacological side effects. With this in mind we did a systematic review to look at alternative and complementary medicine to decrease analgesic and anxiolytic use.

Eight studies used music, transcutaneous electrical nerve stimulation (TENS), acupressure, or acupuncture as complementary therapy during SWL. These studies were all randomised controlled trials (RCTs) in English language done in human subjects during their renal or ureteric stone treatment.

Acupuncture was the most popular and widespread complementary therapy. Pain control/analgesia requirement was significantly better in 4 studies (music-2, acupuncture-1, TENS -1). There was a reduction of fentanyl requirement with the use of music in two studies and the use of TENS in one study. Significantly lower anxiety was noted in one study with music and one with acupuncture. There was no significant difference in SFR with the use of complementary therapy. No major or minor side effects were noted with the use of complementary therapy.

Our review leads us to suggest that complementary therapy for SWL can help lower analgesia requirements and the anxiety associated with it in some cases. However, it does not have any effect on the stone-free rates achieved.

Written by:
B. K. Somani as part of Beyond the Abstract on This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK

Complementary approaches to decreasing discomfort during shockwave lithotripsy (SWL) - Abstract

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