Abstract
BACKGROUND This study was conducted to check whether computer tomography (CT) parameter Hounsfield Unit has any bearing on outcome of ureteroscopic pneumatic lithotripsy and as to whether it can predict success rate of ureteroscopic lithotripsy in the management of ureteric calculus. CT Hounsfield Unit tells us about hardness of stone, and it is primarily important in non-invasive management of ureteric and renal calculus such as extracorporeal shock wave lithotripsy (ESWL). METHODS We retrospectively reviewed records of 420 patients who underwent URSL from January 2016 to January 2020. A total of 186 patients of ureteric calculus did undergo CT in pre-operative evaluation for stone. Data of those patients was taken for study. Intra op clearance of calculus was decided by ureteroscopy finding on the table. All complications and difficulties of the procedure were documented. RESULTS We analysed the correlation between the outcome of the URSL and Hounsfield unit in finding the position of the stone and size of the stone. Out of 186 study participants, 111 (59.6 %) patients needed a single procedure for stone clearance whereas 75 (40.4 %) needed multiple procedures for clearance. Out of 186, 22 had HU < 500, 112 had HU 501 - 1000, 52 had HU > 1000. The majority of patients had HU between 501 - 1000HU. Complete clearance was seen in 63.6 % of < 500 HU patients, 62.5 % of 501 - 1000 HU patients and 55.7 % of > 1000 HU patients. This difference in clearance was statistically not significant. Similarly, the rate of complication when compared among the three groups doesn’t show a statistically significant difference (P value 0.293). The requirement of repeat procedure was maximum in > 1000 HU patients but the difference between the three groups was not statistically significant. Stone migration rate was found to be more in > 1000 HU stones (80.76 %) and this was statistically significant. CONCLUSIONS To conclude CT Hounsfield Unit’s utility in predicting the stone-free rate and complication rate doesn’t show significant bearing in patient undergoing URSL procedure. KEYWORDS CT, Hounsfield Unit, URSL, Stone Free Rate, Stone Density, Complication
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