The purpose of this study was to evaluate the efficacy of transcutaneous focused ultrasound for repositioning ureteral stones and facilitating transit in conscious patients. The participants were adults who had been clinically diagnosed with a stone in either the proximal or distal ureter. 

Awake, non-sedated patients had ultrasonic propulsion alone or in combination with burst wave lithotripsy delivered by a handheld transducer. Stone movement, stone passage, and pain reduction were all indicators of success. The expected or unfavorable occurrences were reported as a safety consequence. 

Stone movement was seen in 19 (66%) of the 29 patients who got either ultrasonic propulsion alone (n = 16) or with burst wave lithotripsy bursts (n = 13). In 18 of 21 cases with distal ureteral stones with at least 2 weeks of follow-up, the stone passed between 3.9 ± 4.9 days after the surgery. Of the cases treated with burst wave lithotripsy, 7 showed signs of fragmentation. All individuals were able to undergo the treatment with no complications, and the average pain score (out of 10) decreased from 2.1±2.3 to 1.6±2.0 (P =.03). Hematuria during the first urine post-procedure and slight discomfort were the only complications expected. Only 2.2% (18 of 820) of propulsion bursts were linked with any discomfort for any of the 7 patients. 

This research lends credence to the use of ultrasonic propulsion and burst wave lithotripsy to reposition and break ureteral stones in awake people, hence alleviating pain and easing transit.

Source: www.auajournals.org/doi/10.1097/JU.0000000000002864