Predictors of Success Outcomes in Nurse‐Led Extracorporeal Shock Wave Lithotripsy for Nephrolithiasis: A Prospective Observational Study
Tori Nedregård Økdal, Geir Egil Eide, Harriet Birke, Leslie S. P. EideABSTRACT
Aim
To identify clinical, anatomical, and technical predictors associated with successful extracorporeal shock wave lithotripsy (ESWL) outcomes in patients with nephrolithiasis undergoing nurse‐led ESWL treatment.
Design
Prospective descriptive observational study.
Methods
A total of 461 ESWL treatments for nephrolithiasis performed between November 2016 and June 2024 at St. Olav's University Hospital, a tertiary university hospital in Trondheim, were analysed. A consecutive sampling strategy was used to minimize selection bias. Data on stone characteristics (size, density, and anatomical location) and treatment‐related parameters were extracted from patient records. These variables were selected based on recommendations from the European Association of Urology. Logistic regression was used to identify predictors of treatment success (defined as stone‐free or residual fragments ≤ 4 mm).
Results
Three variables were associated with treatment success: stone laterality, size and density. Right‐sided stones were more likely to be successfully treated (OR 1.77, p = 0.004), while larger and denser stones were less likely to achieve complete clearance (OR 0.91, p = 0.003 and OR 0.99, p = 0.012 respectively). The overall success rate was comparable to outcomes reported for urologist‐led procedures.
Conclusion
ESWL performed by trained nurses seems to be safe and effective. Findings support an expanded nursing role in advanced urological procedures and provide knowledge that can improve patient selection and resource utilization.
Implications for the Profession and/or Patient Care
Nurse‐led ESWL appears to achieve success rates comparable to physician‐led models when delivered by appropriately trained nurses.
Impact
This study adds evidence for task shifting in specialized healthcare settings and demonstrates that nurses can deliver high‐quality treatment. The findings have implications for competence development, patient access, and efficient use of urological resources.
Reporting Method
STROBE.
Patient or Public Contribution Reporting Method
No Patient or Public Contribution.