{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:22:29Z","timestamp":1768000949650,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the efficacy and safety of ultraslow full\u2010power versus slow rate, power\u2010ramping shock wave lithotripsy in the management of stones with a high attenuation value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized comparative study enrolling patients with single high attenuation value (\u22651000\u00a0Hounsfield unit) stones (\u22643\u00a0cm) between September 2015 and May 2018. Patients with skin\u2010to\u2010stone distance &gt;11\u00a0cm or body mass index &gt;30\u00a0kg\/m<jats:sup>2<\/jats:sup> were excluded. Electrohydraulic shock wave lithotripsy was carried out at rate of 30\u00a0shock waves\/min for group\u00a0A versus 60\u00a0shock waves\/min for group\u00a0B. In group\u00a0A, power ramping was from 6 to 18\u00a0kV for 100\u00a0shock waves, then a safety pause for 2\u00a0min, followed by ramping 18\u201322\u00a0kV for 100\u00a0shock waves, then a safety pause for 2\u00a0min. This full power (22\u00a0kV) was maintained until the end of the session. In group\u00a0B, power ramping was carried out with an increase of 4\u00a0kV each 500\u00a0shock waves, then maintained on 22\u00a0kV in the last 1000\u20131500\u00a0shock waves. Follow up was carried out up to 3\u00a0months after the last session. Perioperative data were compared, including the stone free rate (as a primary outcome) and complications (secondary outcome). Predicting factors for success were analyzed using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 100 patients in group\u00a0A and 96 patients in group\u00a0B were included. The stone\u2010free rate was significantly higher in group\u00a0A (76% <jats:italic>vs<\/jats:italic> 38.5%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Both groups were comparable in complication rates (20% <jats:italic>vs<\/jats:italic> 19.8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.971). The stone\u2010free rate remained significantly higher in group\u00a0A in logistic regression analysis (odds ratio 24.011, 95% confidence interval 8.29\u201369.54; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultraslow full\u2010power shock wave lithotripsy for high attenuation value stones is associated with an improved stone\u2010free rate without affecting safety. Further validation studies are required using other shock wave lithotripsy machines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14158","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T08:27:16Z","timestamp":1575361636000},"page":"165-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Ultraslow full\u2010power shock wave lithotripsy versus slow power\u2010ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study"],"prefix":"10.1111","volume":"27","author":[{"given":"Ahmad A","family":"Al\u2010Dessoukey","sequence":"first","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman S","family":"Moussa","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Sayed","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M","family":"Abdelbary","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabie","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr M","family":"Massoud","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed H","family":"Abdelhamid","sequence":"additional","affiliation":[{"name":"Urology Department Faculty of Medicine Cairo University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akram A","family":"Elmarakbi","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M","family":"Ragheb","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed S","family":"ElSheemy","sequence":"additional","affiliation":[{"name":"Urology Department Faculty of Medicine Cairo University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Ghoneima","sequence":"additional","affiliation":[{"name":"Urology Department Faculty of Medicine Cairo University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"T\u00fcrkC NeisiusA PetrikAet al.EAU guidelines on urolithiasis: 2018 update. 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