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Original Research Article Background: Extra-corporeal shock wave lithotripsy (ESWL) is the important mode of stone management for the patients who are fulfilling the criteria for fragmentation and clearance using shock waves. ESWL only helps in fragmentation. Clearance is done by the diuresis. In this study we aim to compare stone clearance with ESWL procedure using diuretics and fluids versus fluid alone. Material and methods: This is a prospective parallel arm randomized open label single center study conducted at Indira Gandhi institute of medical sciences (IGIMS), Patna between January 2019 to December 2019. Inclusion: Patients between 18 to 60 years of age with solitary renal stone of size less than 1.5 cm measured on ultrasound. Any patient having coagulopathy, positive urine culture, altered anatomy of urinary system etc. are excluded from the study. Enrolled patients were randomized to either standard group or diuretic group. Diuretic group received diuretic in the form of injection furosemide 20 mg slow iv along with continuous 0.9% Normal Saline (NS) during the procedure (total 1 liter) while standard group received only 0.9% NS infusion during the procedure. Outcome: Clearance was measured as residual stone after 3 months of last session of ESWL using X ray, ultrasound and NCCT KUB. Result: 130 patients were screened and 94 were found eligible for randomization. Baseline characteristics were similar in both groups. Average size of stone was 1.75±0.2 cm in the standard group and 1.64 ±0.3 in the diuretic group. In our present study, the stone clearance rate was significantly better in diuretic group as compared to standard group (82.97% vs 59.57% P < 0.05). Conclusion: We conclude that there is a beneficial role of using diuretics along with hydration in renal stone fragmentation and clearance as compared with hydration alone.

Does Diuretic During Extra-Corporeal Shock Wave Lithotripsy (ESWL) Really Help in Stone Fragmentation and Clearance?