Category: Clinical Stones: SWL

MP31-22 - Role Of Triple D Score To Predict The Stone Free Rate Post Shock Wave Lithotripsy: Our Experience

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

The Triple D Score is a scoring system, which incorporates three metrics - stone density, stone volume (dimensions), and skin-to-stone distance (SSD), to augment the prediction of extracorporeal shock wave lithotripsy (ESWL) treatment outcome. Our objective is to predict the efficacy of ESWL stone free rates using Triple D scoring system.


Methods :

A retrospective analysis was performed over a period of 1 year at MPUH, retrieving 50 cases of renal and upper ureteric stones who underwent ESWL with available preoperative CT scan. In all the cases stone density, ellipsoid stone volume (ESV) and skin to stone distance (SSD) was determined and triple D score was calculated. The ROC curves were established to determine the cut off value for each parameter.


Results :

Thirty six out of 50 patients (72%) who underwent ESWL were stone free after single session treatment. ESV, SSD, and stone density were significant predictors of ESWL success. Based upon the ROC curves, cutoffs of <150 mmfor ESV, <85 mm for SSD, and <900 HU for stone density were established. A Triple D Score of 0, 1, 2, and 3 correlated with ESWL success rates 50.0%, 62.5%, 80%, and 87.5% respectively.


Conclusions :

The Triple D Score appears to be a useful predictor of ESWL treatment outcomes. The use of ESWL in patients with score 2 or above shall allow us to improve operative outcomes and guide us for suitable patient identification.

Rohit Maheshwari

Resident
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Vikas Garg

Resident
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Arvind Ganpule

Vice Chairman
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Sudharsan Balaji

Fellow in Endourology, Laparoscopy and Robotics
Dr.
Nadiad, Gujarat, India

I am Dr. Sudharsan Balaji, MBBS MS MRCS DNB (Urology), working as a Fellow in Endourology, laparoscopy and Robotics in Muljibhai Patel Urological Hospital, Nadiad, India. I finished my Undergraduation and Postgraduation from Stanley Medical College, Chennai in 2009 and 2013 respectively. I finished ny Urological degree from my almamater MPUH, Nadiad in 2017 and was awarded the Endourological Society Fellowship on the same year. I have 15 publications to my credit, authored 3 book chapters and associate editor of a book titled "Monograph Series in Urology - Endourology and laparoscopy". I have so far 14 national and international presentations in various urological conferences till date. I was offered a visiting Scholarship in Pediatric Urology in Cincinnati Childrens' Hospital in 2015. I have specific interests in Endourology, Transplant and Minimally invasive pediatric urology. I see myself as laparoscopic/Robotic pediatric reconstruction in the future, which is my area of interest and expertise.

Ravindra Sabnis

Chairman
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India

Mahesh Desai

Consultant Urologist and Managing Trustee
Muljibhai Patel Urological Hospital
Nadiad, Gujarat, India