Abstract
Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods: During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens- LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done. Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re- treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions: Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.
Highlights
The only expulsive treatment for urinary stones was the open surgery, until the 1980
Post-extracorporeal shock wave lithotripsy (ESWL) complications were observed in 5 subjects (3.5%)
Sex, nationality, stonenature and ureteric stenting had no significant impact on the success rate
Summary
The only expulsive treatment for urinary stones was the open surgery, until the 1980. Afterwards, extracorporeal shock wave lithotripsy (ESWL) was introduced as novel and alternative treatment method to conventional surgical method. Ever since, it has become the most preferred treatment modality for the renal, proximal and mid ureteral stones. With the advantage of high efficiency and low morbidity rates, ESWL has become the therapy of choice for small renal stones due to the less invasive procedure as compared to open nephrolithotomy. This therapy provides good results, associated with few complications, but it does not change the underlying metabolic abnormality. The patient’s chances of first episode recurrent stone formation range between 27% and 50% [6,7]
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