Prone Position More Effective for Treating Proximal Ureteral Stones with Shock Wave Lithotripsy, finds study

A recent multi-center study revealed that the prone position is significantly more effective than the supine position for treating proximal ureteral stones using ultrasound-guided shock wave lithotripsy (SWL). This study published in the World Journal of Urology was conducted between June 2020 and December 2023 to determine the optimal patient position for maximizing treatment outcomes. 

The prospective study involved a total of 1,187 patients with proximal ureteral stones, divided nearly equally between those treated in the prone (50.5%) and supine (49.5%) positions. This research assessed the stone-free rate (SFR) as the primary outcome, while secondary outcomes included the complete SFR, the number of SWL sessions required, and complication rates. A propensity score-matched (PSM) analysis was performed to ensure fair comparisons between the two groups.

The patients treated in the prone position showed a superior SFR of 85.7% when compared to 77.4% in the supine position (P = 0.001). Also, the complete SFR, which measures the total elimination of stones, was higher in the prone group at 83.3%, versus 75.0% in the supine group (P = 0.001). Both groups required a similar number of SWL sessions (prone: 1.27, supine: 1.20; P = 0.092), and the complication rates were statistically insignificant across the groups, demonstrating that the prone position does not compromise safety.