You have accessJournal of UrologyStone Disease: Shock Wave Lithotripsy1 Apr 2016MP54-14 OPTIMAL SKIN-TO-STONE DISTANCE IS A POSITIVE PREDICTOR FOR SUCCESSFUL OUTCOMES IN UPPER URETER CALCULI FOLLOWING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY: A BAYESIAN MODEL AVERAGING APPROACH Dong Hyuk Kang, Kang Su Cho, Hae Do Jung, Doo Yong Chung, Jong Kyou Kwon, Jae Hung Jung, Seung Hwan Lee, Won Sik Ham, Young Deuk Choi, and Joo Yong Lee Dong Hyuk KangDong Hyuk Kang More articles by this author , Kang Su ChoKang Su Cho More articles by this author , Hae Do JungHae Do Jung More articles by this author , Doo Yong ChungDoo Yong Chung More articles by this author , Jong Kyou KwonJong Kyou Kwon More articles by this author , Jae Hung JungJae Hung Jung More articles by this author , Seung Hwan LeeSeung Hwan Lee More articles by this author , Won Sik HamWon Sik Ham More articles by this author , Young Deuk ChoiYoung Deuk Choi More articles by this author , and Joo Yong LeeJoo Yong Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.584AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The skin-to-stone distance (SSD), a predictor of extracorporeal shock wave lithotripsy (ESWL) success, remains controversial in patients with ureter stones. Until recently, SSD was a significant factor in half of all published studies. However, in the remaining studies, there was no significant difference in SSD for success or stone-free rate after SWL. Thus, we investigated why SSD was not a predicting factor for successful outcome following ESWL in previous studies. We also determined the optimal SSD, which can be used as a new positive predictor for successful ESWL outcomes in patients with upper ureter stones. METHODS We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4–20 mm and were eligible for our analyses. Maximal stone length (MSL), Hounsfield units (HU), and SSD were determined on pretreatment non-contrast computed tomography (NCCT). For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile. RESULTS In analyses of group 2 patients versus others, there were no statistical differences in mean age, MSL, or HU (Table 1). However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P=0.032). The multivariate logistic regression model revealed that shorter MSL, lower HU, and the group 2 SSD were positive predictors for successful outcomes in ESWL (Table 2). Using the Bayesian model-averaging approach, longer MSL, lower HU, and group 2 SSD can be also positive predictors for successful outcomes following ESWL. CONCLUSIONS Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e731-e732 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Dong Hyuk Kang More articles by this author Kang Su Cho More articles by this author Hae Do Jung More articles by this author Doo Yong Chung More articles by this author Jong Kyou Kwon More articles by this author Jae Hung Jung More articles by this author Seung Hwan Lee More articles by this author Won Sik Ham More articles by this author Young Deuk Choi More articles by this author Joo Yong Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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