Clinical outcome of intravenous urography-assisted shockwave lithotripsy for radiolucent ureteral stones

Abstract

ObjectiveWe aimed to compare the clinical outcome of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones. MethodsWe retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021. The primary outcome was a stone-free rate with one session within 30 days, defined as no residual stones without auxiliary treatment. Multivariate analysis was used to examine whether intravenous urography use predicted treatment success. Furthermore, we compared the outcomes using propensity score matching. ResultsNinety-eight patients underwent intravenous urography use protocol (Group I), and the remaining 636patients underwent non-intravenous urography protocol (Group N). Stone-free rates with one session within 30 days were 37.8% and 31.7% in groups I and N, respectively (p=0.20). No statistical differences were observed in the conversion rate to ureteroscopy (p=0.26) and complication rate (p=0.70) between Group I and Group N. One patient who developed skin redness was considered a complication of the contrast medium. Propensity score matching examined 88 matched pairs. Treatment success was obtained in 31 (35.2%) patients in Group I and 33 (37.5%) patients in Group N (p=0.88) within 30 days with one session. ConclusionsRadiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.