Effect degree of hydronephrosis on the success rate of shock wave lithotripsy in patients with ureteral calculi

Abstract

Objective To investigate the effect of the degree of hydronephrosis on the success rate of shock wave lithotripsy (SWL) in patients with ureteral calculi (UC). Methods From January 2013 to May 2017, 420 patients with UC received SWL in our hospital were selected as study subjects. The patients were divided into the successful group (n=310) and the failure group (n=110) according to success of stone removal 3 months after the operation. The differences in clinical characteristics between the two groups were compared, and the differences of clinical features in patients with different hydronephrosis groups were compared. Univariate and multivariate logistic regression analysis were used to investigate the risk factors of success of SWL in UC patients. Results The stone heterogeneity index in successful group was significantly higher than in failure group (P<0.05), the age, stone diameter, stone density and severity of hydronephrosis were significantly lower than those of failure group (P<0.05). The patients with different degree of hydronephrosis had significant differences in sex, stone site, stone diameter, stone density, and one-session success (P<0.05). Univariate and multivariate logistic regression analysis showed that stone diameter≥10.00 mm, stone density≥700.00 HU, stone heterogeneity index≤235.00 HU, degree of hydronephrosis≥3 grade could increase risk of failure of SWL surgery in UC patients (P<0.05). Conclusions The 3 and 4 levels of renal hydronephrosis before operation are not beneficial to the effect of SWL in UC patients. Key words: Ureteral Calculi; Lithotripsy; Hydronephrosis