1571 WHICH OF RENAL STONE CHARACTERISTICS IN NONCONTRAST COMPUTED TOMOGRAPHY CAN PREDICT SUCCESSFUL TREATMENT BY SHOCK WAVE LITHOTRIPSY? UNIVARIATE AND MULTIVARIATE ANALYSIS

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal II1 Apr 20101571 WHICH OF RENAL STONE CHARACTERISTICS IN NONCONTRAST COMPUTED TOMOGRAPHY CAN PREDICT SUCCESSFUL TREATMENT BY SHOCK WAVE LITHOTRIPSY? UNIVARIATE AND MULTIVARIATE ANALYSIS Adel Elbakry, Mokhtar Metaewea, Mohamed El Koshy, and Ahmed El Nashar Adel ElbakryAdel Elbakry More articles by this author , Mokhtar MetaeweaMokhtar Metaewea More articles by this author , Mohamed El KoshyMohamed El Koshy More articles by this author , and Ahmed El NasharAhmed El Nashar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1337AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine which of the stone characteristics in noncontrast computed tomography (NCCT) has a significant and reliable value in predicting the outcome of the treatment of renal stones by extracorporeal shock wave lithotripsy (ESWL). METHODS Forty patients with renal stones were subjected to stone disintegration by ESWL. Patients were 27 males and 13 females aged 32-69 years (mean SD 48.9±7.9). Four patients had bilateral renal stones, thus total stone number was 44. All stones were radio opaque and their NCCT characteristics were determined before ESWL. All patients'data and stones characteristics were analyzed via univariate and multivariate statistical analysis in correlation to the success and failure of ESWL. RESULTS The outcome of ESWL therapy was classified as successful (34 stones) and failed ESWL treatment (10 stones). The range (mean SD) of stone size,stone burden,stone density, skin to stone distance and body mass index (BMI)were 5.8 – 21.8 mm(13.6±3.7), 145 – 3000 mm 3 (1155.44±646.4), 401 – 1325 hounsfield units(HU)(675.8±264.9), 63.07 – 131.7mm(100.01±18.3) and 22.9–33.6(27.9 ± 2.4)respectively. Univariate analysis revealed that the most important factors predicting successful ESWL therapy were Stone density (P=0.001), skin to stone distance (P=0.001), body mass index(P=0.001), stone size (P=0.01), stone burden (P=0,02)and stone location(P=0.04) in descending sort. Receiver operating curve revealed that cut-off value above which failure of ESWL may be expected were stone size ≥14.49mm, stone density ≥993 HU, skin to stone distance>110.5mm and stone burden ≥ 1600 mm 3. Multivariate analysis showed that the most fitting predicting factors are maximum stone density (P= 0.01), maximum stone size (P=0.01), skin to stone distance (P=0.01) and stone burden (P= 0 0.01). CONCLUSIONS Renal stone characteristics in NNCT can predict success or failure of ESWL particularly stone attenuation (density), skin to stone distance, stone size and stone burden. Other parameters have no valuable effect on the result of ESWL. Thus, determination of NCCT characteristics of a renal stone effectively help in decision making and the patient can be informed about the most probable outcome of ESWL before the treatment. Ismailia, Egypt© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e607 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adel Elbakry More articles by this author Mokhtar Metaewea More articles by this author Mohamed El Koshy More articles by this author Ahmed El Nashar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...