1460 PREDICITION OF RENAL STONE FRAGILITY IN RESPONSE TO SHOCK WAVE LITHOTRIPSY BY THEIR RADIOLOGIC APPEARANCE

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal I1 Apr 20101460 PREDICITION OF RENAL STONE FRAGILITY IN RESPONSE TO SHOCK WAVE LITHOTRIPSY BY THEIR RADIOLOGIC APPEARANCE Mohamed Nady, Alaa AbdelHafez, Mohamed ElKoushy, and Emadeldeen Ali Salah Mohamed NadyMohamed Nady Assiut, Egypt More articles by this author , Alaa AbdelHafezAlaa AbdelHafez Sohag, Egypt More articles by this author , Mohamed ElKoushyMohamed ElKoushy Ismailia, Egypt More articles by this author , and Emadeldeen Ali SalahEmadeldeen Ali Salah Assiut, Egypt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1174AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Extracorporeal shock wave lithotripsy (ESWL) provides a non invasive method for treatment of renal and ureteral calculi. Currently, fluoroscopic stone targeting remains a major component of ESWL. A plain (KUB) film is often required to plan lithotripsy treatment. The appearance of a stone on KUB (size, shape and radiodensity) might give a clue for the success of ESWL. The aim of this work was to evaluate the efficacy of ESWL in treatment of different types of upper urinary tract stones regarding their radiological characteristics like texture homogeneity, surface smoothness and radiodensity degree in relation to last rib. METHODS About 336 patients with single renal pelvic stone less than 2cm were treated by ESWL at 3 centers. The patients were classified based on stone imaging characters. Type I classification was done according to how homogeneous were the stones while type II classification was based on the surface outline of the calculi. Finally, type III classification according to radiodensity degree of stones in relation to last rib as landmark comprised three subclasses with less, equal and more density than last rib. The percentage of stone free rate (SFR) within 3 months post ESWL was calculated. The results were classified based on imaging studies. RESULTS Homogenous stones were 53% clear after ESWL, while the majority (86%) of nonhomogenous stone patients became stone free (p> 0.01). On the other hand, smooth and rough calculi showed 61% and 77% SFR (p> 0.05). Lastly, the SFRs of less, same and more dense stone than the last rib were 82%, 69% and 56% respectively. CONCLUSIONS The efficacy of ESWL in treatment of different types of upper urinary stones is related to the radiological characteristics of the stone. Stones which are heterogonous, rough or less dense in KUB film are more likely to disintegrate by ESWL © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e562 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Nady Assiut, Egypt More articles by this author Alaa AbdelHafez Sohag, Egypt More articles by this author Mohamed ElKoushy Ismailia, Egypt More articles by this author Emadeldeen Ali Salah Assiut, Egypt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...