It is important to improve treatment efficacy in the management of urolithiasis in respect of time saving cost effectiveness. An experimental study reported that optimal fluid act as an interface between stone and urothelium improves fragmentation. We investigated the effect of diuretic usage in the SWL treatment of urolithiasis.

Sixty renal stone patients were selected for the prospective randomized double blind study. Patient in group A were given a placebo injection and patient in group B were given 20mg IV furosemide at the time of SWL treatment. Both groups received standard SWL monotherapy using Modulith SLX2000 lithoclast(Storz®, Germany). The energy setting, number of shock waves per session were identical in both groups. Treatment results were compared three weeks later after the first SWL treatment.

Mean age of the patients was 44.5±11.3 years old in group A, and 43.1±11.5 years old in group B. Mean size of the calculus before treatment were 9.2±4.8, and 8.9±5.1mm, which did not shown any statistical difference(p>0.05). Three weeks after the treatment, stone fragmentation and stone free rate was significantly higher in group B(p<0.05).

This study suggest that administration of furosemide intravenously during SWL improve stone fragmentation and stone free rate.