1832 OUTCOMES FOLLOWING SECONDARY TREATMENT USING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111832 OUTCOMES FOLLOWING SECONDARY TREATMENT USING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY Adam Stewart, Wesley White, and Frederick Klein Adam StewartAdam Stewart Knoxville, TN More articles by this author , Wesley WhiteWesley White Knoxville, TN More articles by this author , and Frederick KleinFrederick Klein Knoxville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1851AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventional treatment of renal and upper ureteral calculi includes ureteroscopy (URS) and Extracorporeal Shock Wave Lithotripsy (ESWL). Although initial treatment success rates with ESWL approach 90%, select patients will require a second treatment. URS is often employed in this scenario despite limited data regarding treatment success following repeat ESWL. We present outcomes following re-treatment of stones using ESWL in a large observational cohort of patients. METHODS A retrospective review was performed to determine the efficacy and perioperative outcomes following secondary treatment of renal and ureteral calculi using ESWL. Following initial treatment with ESWL, patients who were defined as treatment failures were offered repeat ESWL or URS. Patients who underwent secondary treatment with ESWL were followed postoperatively and routine aftercare was performed. Post-treatment imaging included KUB or non-contrast CT at 30 days. Aftercare reports were completed and catalogued in a prospectively maintained database. Success was defined as the absence of stones or the presence of fragments less than 4mm. RESULTS Between 1/1/2000 and 12/31/2009, 14,313 patients underwent 22,463 treatments for renal or ureteral calculi by ESWL. Mean stone size was 9.04mm. Success rate with initial treatment was 91%. A total of 617 patients underwent secondary treatment with ESWL. Mean stone size was 1.24cm. Success was achieved in 75% of patients. Among patients that underwent repeat treatment, success rates were highest among patients with a stone size less than 1cm. Stone location did not appear to impact secondary treatment outcomes. CONCLUSIONS Based on our large, single-center experience, secondary treatment with ESWL continues to offer a high overall success rate. Although URS should be strongly considered following initial treatment failure, patients who request or are better suited for ESWL can be offered repeat treatment with a high level of confidence. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e734-e735 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Stewart Knoxville, TN More articles by this author Wesley White Knoxville, TN More articles by this author Frederick Klein Knoxville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...