Kidney Stones: Pushing Fragments Could Be Key to Reducing Recurrence Risk, Study Reveals
UW Medicine researchers found that patients who underwent the stone-moving ultrasound procedure had a 70% lower risk of recurrence. The Journal of Urology published the findings.
“I think the main takeaways of this study are removing fragments reduces relapse and using a noninvasive, hand-held ultrasound device to help clear these kidney stone fragments,” said UW Medicine urologist Dr. Jonathan Harper, the study’s senior author.
The multisite, randomized and controlled trial was conducted from May 2015 to April 2024. Almost all of the 82 participants were from the UW Medicine or the VA Puget Sound health systems. All had stone fragments that had persisted in their kidneys for months, and their ureters were free of stones and fragments.
In the study, 40 underwent ultrasound treatment to encourage fragments to clear from the kidneys, while 42 control-group members received no such treatment.
With patients awake in a clinic office setting, doctors used a wand that generated ultrasonic pulses through the skin to move the fragments closer to the ureter, where they could be naturally expelled, sometimes with the next urination, Harper noted.
Harper and his co-lead author on the paper, urologist Dr. Mathew Sorensen, have worked on this technology and treatment for 15 years. They also use this technology, called burst wave lithotripsy, to blast larger stones into smaller pieces; those successes were published in 2022.
The pushing and breaking technologies are used with the same ultrasound platform.
“I see a lot of potential in this It could become as common as getting your teeth cleaned. If you have a couple of small stones which could cause future problems, you make an office appointment and in 30 minutes you’re done.“This could really revolutionize kidney stone treatment,” Harper said.
Reference: Sorensen MD, Dunmire B, Thiel J, Cunitz BW, Burke BH, Levchak BJ, Popchoi C, Holmes AE, Kucewicz JC, Hall MK, Dighe M, Dai JC, Cormack FC, Liu Z, Bailey MR, Porter MP, Harper JD. Randomized Controlled Trial of Ultrasonic Propulsion-Facilitated Clearance of Residual Kidney Stone Fragments vs Observation. J Urol. 2024 Aug 14:101097JU0000000000004186. doi: 10.1097/JU.0000000000004186. Epub ahead of print. PMID: 39146526.
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