Category: Clinical Stones: SWL
Introduction & Objective : The aim of this study was to identify the factors that affect the success of extracorporeal shockwave lithotripsy (SWL) for ureteral stones.
Methods : We retrospectively reviewed the medical records of 1079 patients who had undergone SWL between June 2015 and September 2017. Of 1079 patients, 473 had ureteral stones treated with SWL. Patients’ demographics, stone characteristics and SWL data were analyzed. The patients with prior history of SWL to the stone and congenital or acquired anatomical anomaly of genitourinary tract were excluded. Success was defined as no detectable fragment on KUB (Kidney,Ureter, Bladder) or Non-contrast Computerized Tomography (NCCT) at the end of 4 weeks of follow up. The patients were classified into two groups as SWL-failed and SWL-successfull; and compared based on patients’, stone and SWL features.
Results : There were no statistical significance between the 2 groups (Group 1, SWL-failed; group 2, SWL-successfull) in terms of sex, stone laterality, body mass index (BMI), waist circumference, previous stone passage history, previous SWL or stone surgery, family history for urolithiasis and ureteral stone localization (proximal, mid- or distal ureteral stone). Mean stone burden, radiation exposure and treatment time were 73,53±54,82 (9-500) mm2, 59,13±12,11 (20-150) sec and 29,14±5,73 (10-120) min, respectively. Of the 473 patients, 335 ,after mean SWL sessions of 1,66±0,80 (1-6), was stone free (70.8%). The stone free rate (SFR) was %82,8 in patients with ureteral stones smaller than 10 mm. Surgery was needed in 123 cases (%26) after SWL failure. SFR was significantly higher in younger patients (p<0,05). Patients in stone free group had statistically smaller stone volumes according to failure group (p<0,0001).
Despite the new minimally invasive technologies, SWL is still the primary option for ureteral stones. SWL success seems to be higher in younger patients and less stone burden.
Erkan Erkan– Istanbul, Istanbul, Turkey
Ugur Yucetas– Istanbul, Istanbul, Turkey
Nejdet Karsiyakali– Istanbul, Istanbul, Turkey
Erkan Sonmezay– Istanbul, Istanbul, Turkey
Mustafa Kadihasanoglu– Istanbul, Istanbul, Turkey
Ali Ferruh Akay– Istanbul, Istanbul, Turkey