Abstract
Purpose This study was conducted to evaluate colic pain as a prognostic pretreatment factor that can influence ureter stone clearance and to estimate the probability of stone-free status in shock wave lithotripsy (SWL) patients with a ureter stone. Materials and Methods We retrospectively reviewed the medical records of 1,418 patients who underwent their first SWL between 2005 and 2013. Among these patients, 551 had a ureter stone measuring 4–20 mm and were thus eligible for our analyses. The colic pain as the chief complaint was defined as either subjective flank pain during history taking and physical examination. Propensity-scores for established for colic pain was calculated for each patient using multivariate logistic regression based upon the following covariates: age, maximal stone length (MSL), and mean stone density (MSD). Each factor was evaluated as predictor for stone-free status by Bayesian and non-Bayesian logistic regression model. Results After propensity-score matching, 217 patients were extracted in each group from the total patient cohort. There were no statistical differences in variables used in propensity- score matching. One-session success and stone-free rate were also higher in the painful group (73.7% and 71.0%, respectively) than in the painless group (63.6% and 60.4%, respectively). In multivariate non-Bayesian and Bayesian logistic regression models, a painful stone, shorter MSL, and lower MSD were significant factors for one-session stone-free status in patients who underwent SWL. Conclusions Colic pain in patients with ureter calculi was one of the significant predicting factors including MSL and MSD for one-session stone-free status of SWL.
Highlights
Since the introduction of shock wave lithotripsy (SWL) in the early 1980s, significant improvements have been made in shockwave technology and safety [1]
We retrospectively reviewed the medical records of 1,418 patients who underwent their first SWL between 2005 and 2013
Several studies have demonstrated that the consistency, size, shape, location, and Hounsfield units (HU) of the ureteral stone and the BMI of patients have been significant factors that predict the outcome in SWL [4,5]
Summary
Since the introduction of shock wave lithotripsy (SWL) in the early 1980s, significant improvements have been made in shockwave technology and safety [1]. Several studies have demonstrated that the consistency, size, shape, location, and Hounsfield units (HU) of the ureteral stone and the BMI of patients have been significant factors that predict the outcome in SWL [4,5]. The success rate or stone-free rate may be related to other clinical factors including symptom severity, patient expectations, associated infections, solitary kidney, and abnormal ureteral anatomy [6]. As the most common symptom in patients with ureter calculus, was related to ureteral wall edema and hydronephrosis. In several studies, colic pain as another patient factor has not been evaluated for predicting factors after SWL. The goals of this study were to evaluate prognostic factors, including colic pain before SWL, to estimate the probability of stone-free status using a Bayesian logistic regression model
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