Abstract
The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL. Methods: A total of 417 patients harboring renal or ureteral stones underwent extracorporeal shock wave lithotripsy (ESWL) between October 2008 and July 2012. Eighty five patients were lost on follow up. The remaining (n = 332). All patients were >18 yr of age. Siemens and SLX-F2 electromagnetic machines were used to impart shock waves. Patients were stratified according to localization (pelvic, calyceal, or ureteral stones) and stone size (up to 10 mm, 10 - 20 mm, and >20 mm). Result: The overall success rate was 251/332 (75.6%) achieve stone free status. Repeated ESWL sessions were needed in 258 (61.9%). Of eleven variables were studied including age, sex, side, location (pelvic, calyx, ureter), ureteric stent, previous renal surgery, stone size, number of shock waves, opacity of stone, renal system state, and type of lithotripter, three variables were significantly affect the success rate namely stone size, number of shock waves and location of stone. Conclusions: ESWL remains one of the most commonly utilized treatments for patients with upper urinary tract calculi; Stone diameter, location, and number of shock waves, are the most important predictors determining stone clearance after ESWL of renal and ureteric calculi. To optimize treatment outcomes with ESWL the presence of treating urologist is essential to optimize the final result.
Highlights
Extracorporeal shock wave lithotripsy (ESWL) is considered the first line treatment for the majority of patientsHow to cite this paper: Abid, A.F. (2014) Success Factors of Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal & Ureteric Calculi in Adult
Multiple ESWL treatment sessions were required in 232/332 cases (69%)
Steinstrasse were recorded in 35 cases (10.5%) and passed spontaneously in (71%). 5 cases were treated with ESWL on leading fragment, two treated with meatotomy and 2 treated with ureteroscopy and stone extraction; one case ended with ureterolithotomy
Summary
Extracorporeal shock wave lithotripsy (ESWL) is considered the first line treatment for the majority of patientsHow to cite this paper: Abid, A.F. (2014) Success Factors of Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal & Ureteric Calculi in Adult. Extracorporeal shock wave lithotripsy (ESWL) is considered the first line treatment for the majority of patients. How to cite this paper: Abid, A.F. (2014) Success Factors of Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal & Ureteric Calculi in Adult. There is a considerable variability in reported treatment results of SWL with success rates from contemporary series varying from 60% to 90% [1]-[4]. Many factors are thought to influence the final results of ESWL, including patient selection, stone size, stone location and lithotripter type, in addition to experience level of the operator, total shock number, energy delivered, shock frequency and method of shock delivery [5] [6]
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