Background Obesity significantly increases the risk of developing urinary tract stones, particularly distal ureteral stones, which can complicate treatment with extracorporeal shockwave lithotripsy (SWL). In obese patients, the distance between the skin and the stone often exceeds the effective shockwave range, reducing SWL efficacy. This study presents an innovative SWL assistive device designed to address this challenge by using natural body passages such as the rectum or vagina to shorten the distance between the skin and the stone. Methods Three obese patients with distal ureteral stones who were initially unsuitable for conventional SWL due to excessive skin-to-stone distance were included. An assistive device was used via natural body passages to reduce the skin-to-stone distance during SWL. Clinical outcomes were assessed by postoperative imaging. Descriptive analysis was performed. Result In three obese patients with distal ureteral stones, the use of the device allowed SWL to be performed effectively, with no residual stones detected on follow-up imaging. The device has been patented in China (Patent No.: ZL 2020 2 2018950.0) and is undergoing larger-scale clinical trials to further evaluate its safety and efficacy. Conclusions This development offers a promising solution for obese patients who were previously unable to undergo effective SWL treatment. Trial registration Not applicable.
Zhang et al. (Sat,) studied this question.