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Purpose <p>To evaluate whether externally applied mechanical vibration (an EPVL-based approach) improves stone passage when used as an adjunct to medical expulsive therapy (MET) in patients with distal ureteral stones ≤ 10&#xa0;mm.</p> Methods <p>In this prospective observational cohort study, 697 patients with unilateral distal ureteral stones were stratified by size (≤ 5&#xa0;mm vs &gt; 5&#xa0;mm) and managed with observation, tamsulosin-based MET, externally applied mechanical vibration (an EPVL-based approach), or vibration combined with MET. The primary endpoint was cumulative stone passage within 4&#xa0;weeks. Secondary endpoints included complications (Clavien–Dindo classification) and requirement for ureterorenoscopy (URS).</p> Results <p>EPVL-based strategies were associated with higher early stone passage rates in both size groups. In stones ≤ 5&#xa0;mm, final stone-free rates were high across all strategies (83.3–95.3%; <i>p</i> = 0.081), suggesting a primary effect on time to passage. In stones &gt; 5&#xa0;mm, week-4 stone-free rates were significantly higher with MET (78.3%), EPVL (81.0%), and EPVL + MET (88.4%) compared with observation (53.9%) (<i>p</i> &lt; 0.001). Complication rates were higher in stones &gt; 5&#xa0;mm than in ≤ 5&#xa0;mm (13.7% vs 4.6%; <i>p</i> &lt; 0.001), without significant differences between management strategies.</p> Conclusion <p>Externally applied mechanical vibration may serve as a safe and pragmatic noninvasive adjunct to MET. It was associated with faster stone passage and higher stone-free rates in distal ureteral stones &gt; 5&#xa0;mm without an apparent increase in complication risk.</p>

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External mechanical vibration as an adjunct to medical expulsive therapy for distal ureteral stones ≤ 10 mm: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年4月3日

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  • Mehmet Sevim,
  • Emrullah Durmus

摘要

Purpose

To evaluate whether externally applied mechanical vibration (an EPVL-based approach) improves stone passage when used as an adjunct to medical expulsive therapy (MET) in patients with distal ureteral stones ≤ 10 mm.

Methods

In this prospective observational cohort study, 697 patients with unilateral distal ureteral stones were stratified by size (≤ 5 mm vs > 5 mm) and managed with observation, tamsulosin-based MET, externally applied mechanical vibration (an EPVL-based approach), or vibration combined with MET. The primary endpoint was cumulative stone passage within 4 weeks. Secondary endpoints included complications (Clavien–Dindo classification) and requirement for ureterorenoscopy (URS).

Results

EPVL-based strategies were associated with higher early stone passage rates in both size groups. In stones ≤ 5 mm, final stone-free rates were high across all strategies (83.3–95.3%; p = 0.081), suggesting a primary effect on time to passage. In stones > 5 mm, week-4 stone-free rates were significantly higher with MET (78.3%), EPVL (81.0%), and EPVL + MET (88.4%) compared with observation (53.9%) (p < 0.001). Complication rates were higher in stones > 5 mm than in ≤ 5 mm (13.7% vs 4.6%; p < 0.001), without significant differences between management strategies.

Conclusion

Externally applied mechanical vibration may serve as a safe and pragmatic noninvasive adjunct to MET. It was associated with faster stone passage and higher stone-free rates in distal ureteral stones > 5 mm without an apparent increase in complication risk.