Abstract
ABSTRACTPurpose:To evaluate the patient and stone related factors which may influence the final outcome of SWL in the management of ureteral stones.Materials and Methods:Between October 2011 and October 2013, a total of 204 adult patients undergoing SWL for single ureteral stone sizing 5 to 15 mm were included into the study program. The impact of both patient (age, sex, BMI,) and stone related factors (laterality, location, longest diameter and density as CT HU) along with BUN and lastly SSD (skin to stone distance) on fragmentation were analysed by univariate and multivariate analyses. Results: Stone free rates for proximal and distal ureteral stones were 68.8% and 72.7%, respectively with no statistically significant difference between two groups (p=0.7). According to univariate and multivariate analyses, while higher BMI (mean: 26.8 and 28.1, p=0.048) and stone density values (mean: 702 HU and 930 HU, p<0.0001) were detected as statistically significant independent predictors of treatment failure for proximal ureteral stones, the only statistically significant predicting parameter for the success rates of SWL in distal ureteral stones was the higher SSD value (median: 114 and 90, p=0.012).Conclusions:Our findings have clearly shown that while higher BMI and increased stone attenuation values detected by NCCT were significant factors influencing the final outcome of SWL treatment in proximal ureteral stones; opposite to the literature, high SSD was the only independent predictor of success for the SWL treatment of distal ureteral stones.
Highlights
Following its clinical introduction by Chaussy et al [1] in 1980 extracorporeal shock wave lithotripsy (SWL) became the most common treatment modality with its safe and successful results in renal as well as ureteral stones [2]
Regarding the parameters evaluated so far, many studies did clearly demonstrate that success rates may be related to both patient, and stone related factors [3,4,5,6,7,8]
We aimed to analyse the possible predictive factors detected by pre-procedural unenhanced abdominopelvic computed tomography (NCCT) to assess the success rates of SWL in the management of ureteral stones
Summary
Following its clinical introduction by Chaussy et al [1] in 1980 extracorporeal shock wave lithotripsy (SWL) became the most common treatment modality with its safe and successful results in renal as well as ureteral stones [2]. Regarding the parameters evaluated so far, many studies did clearly demonstrate that success rates may be related to both patient (body mass index=BMI, skin to stone distance =SSD), and stone related factors (location, longest diameter and density in CT hounsfield unit =HU) [3,4,5,6,7,8]. Majority of these studies have mostly examined the outcomes of kidney stones treated with SWL. These factors have not been evaluated enough for the success rate of ureterolithotripsy with SWL in the literature
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