Is there significance of the choice of prone versus supine position in thetreatment of proximal ureter stones with extracorporeal shock wave lithotripsy?

Objective: To determine whether there is a significance of the choice of pr one versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithothripsy (ESWL). Methods: Ninety-six patients with proximal ureter stones underwent ESWL. Th e procedure was performed in the supine position in 48 of them (group 1) an d in the prone position in the other 48 patients (group 2). Stone-free rate s, repeat ESWL rates, shocks per patient and shocks per session were compar ed in both groups. Results: The mean session number per patients was 1.64+/-0.75 in group 1 an d 1.33+/-0.59 in group 2 (p = 0.224). The stone-free rates 3 months after E SWL were 88.3% in group 1 and 90.6% in group 2. The difference between the results was statistically insignificant (p<0.05). Therefore, these two para meters were similar in both groups. On the other hand, the number of shocks per session was 4,863.54+/-2,114.85 in group 1 and 3,704.16+/-1,726.75 in group 2. This difference was statistically significant (p = 0.011). The pat ients tolerated the supine position better in general. Patients in the pron e position experienced discomfort on inspiration and expiration and pain lo calized to the lumbar vertebrae. Conclusion: These results suggest that the supine position decreases the nu mber of shocks per session in the treatment of proximal ureter stones with ESWL and this will be cost-effective. Copyright (C) 2000 S. Karger AG, Base l.