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ESWL as a method for kidney decompression in the treatment of ureteral calculi during the Covid-19 pandemic

Volume 10, Issue 1

Review Article / Published: July 2022


К.Hristov, P. Petrov, O. Gatsev, V. Todorova, K. Petkova, I. Saltirov

Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria


Introduction and objective: The application of ESWL in the treatment of ureteral calculi is to achieve kidney desobstruction with minimal pain, aiming to reduce the need for analgesia and hospital stay. In times of the Covid-19 pandemic by reducing the hospital stay, patients have less contact and it is safer for them from an epidemiological point of view. The objective of our study is to evaluate the efficacy and safety of ESWL as a method of kidney desobstruction caused of ureteral calculi during Covid-19 pandemic.

Material and methods: A retrospectively collected database of 77 patients, who underwent ESWL for ureteral stones between February 2020 and January 2022 in the Clinic of Endourology and SWL, Military Medical Academy, Sofia, Bulgaria, was reviewed. Data on patients’ preoperative characteristics, stone-free rates, complications and auxiliary procedures were analyzed.

Results: Patients’ mean age was 49.1±12.8 years and male-to-female ratio – 75.3%/24.7%. Mean stone length was 6.5±2 mm and mean stone width was 4.5±1.5 mm. Fifty-two (n=52, 67.5%) of the cases were with stones located in the proximal ureter, in the middle ureter (n=14, 18.2%) and in the distal ureter (n=11, 14.3%).  Preoperative drainage with ureteral stent was completed in 13 cases (16.9%). Mean hospital stay was 1.28 days Mean number of SWL hits was 3527±692. Full stone disintegration was observed in 55 patients (71.4%) and partial disintegration was observed in 22 patients (28.6%). Eight (36.4%) of the patients with partial disintegration of the stone needed another ESWL, in 2 (9%) people was performed RIRS afterward and 8 cases (36.4%) required performing an URS at a later stage.

Conclusions: The ESWL as a method of treatment in ureteral calculi has good success rate. With the short hospital stay, it is an appropriate method for times of Covid-19 pandemic. However in some cases, invasive endourological operations such as ureteroscopy could not be avoided in order to be achieved full kidney desobstruction.  


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Click to review Volume 10, Issue 1


Extracorporeal shockwave lithotripsy, ureteral stones, Covid 19

How to cite this article:

Hristov K, Petrov P, Gatsev O, Todorova V, Petkova К, Saltirov I. ESWL as a method for kidney decompression in treatment of ureteral calculi during the Covid-19 pandemic. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2022; 10(1):39-42

Corresponding author:

Dr. Konstantin Hristov

Department of Urology and Nephrology; Military Medical Academy Sofia

Address: Blvd“ Georgi Sofiiski” 3; Sofia-1606, Bulgaria

E-mail: konstantin.hristovv @