Predictive factors of extracorporeal shock wave lithotripsy success for urinary stones

##plugins.themes.academic_pro.article.main##

Badreddine Ben Khalifa
Sahbi Naouar
Wael Gazzah
Braiek Salem
Rafik El Kamel

Abstract

Abstract


Objective: To review with our experience the predictors of stone-free status after extracorporeal shock wave lithotripsy (ESWL) on urinary stones.

Methods: The records of 68 consecutive patients with urinary stones treated with ESWL were reviewed. Patient age, sex, body mass index (BMI), stone dimension, stone Hounsfield density (HD) and stone composition determined by infrared spectroscopic analysis were studied as potential predictors.

Results: Stone Hounsfield density and stone composition were found to be the only predictors of treatment outcome. Stones with lower mean HU levels were more successfully fragmented. The stone density threshold that best distinguished between the outcome groups was 1000 HU. Higher ESWL success rates were found with uric acid and calcium oxalate dihydrate stones.
Conclusions
The results of our study have shown that stone Hounsfield density and stone composition predict for ESWL success.

Keywords:

Stone, extracorporeal shock wave lithotripsy, Predictive factors

##plugins.themes.academic_pro.article.details##

References

  1. Joseph P, Mandal AK, Singh SK, et al. Computerized tomography attenuation value of renal calculus: Can it predict successful fragmentation of the calculus by extracorporeal shock wave lithotripsy? A preliminary study. J Urol 2002;167:1968-71.
  2. Segura JW, Preminger GM, Assimos DG, et al. Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. J Urol 1997;158:1915-21.
  3. Tiselius HG. How efficient is extracorporeal shockwave lithotripsy with modern lithotripters for removal of ureteral stones? J Endourol 2008;22:249-55.
  4. El-Nahas AR, El-Assmy AM, Mansour O, et al. A prospective multivariate analysis of factors predicting stone disintegration by extracorporeal shock wave lithotripsy: the value of high-resolution non contrast computed tomography. Eur Urol 2007;51: 1688-93.
  5. Pareek G, Armenakas NA, Panagopoulos G, et al. Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 2005;65:33-6.
  6. Delakas D, Karyotis I, Daskalopoulos G, et al. Independent predictors of failure of shockwave lithotripsy for ureteral stones employing a second-generation lithotripter. J Endourol. 2003; 17:201-5.
  7. Pareek G, Hedican SP, Lee FT JR, et al. Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology 2005;66:941-4.
  8. Wiesenthal JD, Ghiculete D, D'A Honey RJ, et al. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urological Research 2010;38:307-13.
  9. Azab S, Osama A. Factors affecting lower calyceal stone clearance after extracorporeal shock wave lithotripsy. African J Urol 2013;19:13-7.
  10. Hammad Ather M, Abid F, Akhtar S, et al. Stone clearance in lower pole nephrolithiasis after extracorporeal shock wave lithotripsy - the controversy continues. BMC Urol 2003;3:1.
  11. Perks AE, Gotto G, Teichman JMH. Shock wave lithotripsy correlates with stone density on preoperative computerized tomography. J Urol 2007;178:912-5.
  12. Robert M, A'Ch S, Lanfrey P, et al. Piezoelectric shockwave lithotripsy of urinary calculi: comparative study of stone depth in kidney and ureter treatments. J Endourol. 1999;13:699-703.
  13. Saw KC, McAteer JA, Fineberg NS, et al. Calcium stone fragility is predicted by helical CT attenuation values. J Endourol. 2000;14: 471-4.
  14. Gupta NP, Ansari MS, Kesarvani P, et al. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int 2005;95:1285-8.
  15. Dretler SP, Spencer BA. CT and stone fragility. J. Endourol 2001;15:31-6.
  16. Motley G, Dalrymple N, Keesling C, et al. Hounsfield unit density in the determination of urinary stone composition. Urology 2001;58: 170-3.