Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones?
Objective: To quantify the predictors for the ancillary treatments after extracorporeal shock wave lithotripsy (SWL) for renal and upper ureteral stones. Materials and methods: From January 2014 to January 2017, patients undergoing SWL using an electromagnetic lithotripter machine (Compact Delta;...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2022-12-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/11023 |
| _version_ | 1797975848131756032 |
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| author | Ahmed Ibrahim Adel Elatreisy Abdulghani Khogeer Abdulsalam Ahmadi Shashikant Mishra Mahmoud Faisal Ravindra Sabnis Melanie Aube-Peterkin Serge Carrier Arvind Ganpule Mahesh Desai |
| author_facet | Ahmed Ibrahim Adel Elatreisy Abdulghani Khogeer Abdulsalam Ahmadi Shashikant Mishra Mahmoud Faisal Ravindra Sabnis Melanie Aube-Peterkin Serge Carrier Arvind Ganpule Mahesh Desai |
| author_sort | Ahmed Ibrahim |
| collection | DOAJ |
| description |
Objective: To quantify the predictors for the ancillary treatments after extracorporeal shock wave lithotripsy (SWL) for renal and upper ureteral stones.
Materials and methods: From January 2014 to January 2017, patients undergoing SWL using an electromagnetic lithotripter machine (Compact Delta; Dornier MedTech GmbH, Wessling, Germany) for renal and upper ureteral stones ≤ 20 mm were retrospectively reviewed. All patients underwent CT urography prior to SWL. The cohort was subdivided into three groups according to stone attenuation values in Hounsfield Units (HU). Group I; HU < 500 (n = 20), group II; HU 500-1000 (n = 51) and group III; HU ≥ 1000 (n = 180). The parameters included for multivariate analysis were stone size, location, multiplicity, stone attenuation value, number of shocks and stone clearance rate by 3 months. The ancillary treatments were ureteroscopy (URS), ureteral stenting and hospital readmission for pain or fever.
Results: A total of 251 patients were included in the study. The overall SWL success rate was 92.4%. Mean stone size was 10.9 ± 2.1, 11.6 ± 3 and 11.4 ± 3.6 mm and mean stone attenuation values were 364 ± 125, 811 ± 154 and 1285 ± 171 HU for groups I, II and III respectively. The stone clearance rates by 3 months were 96%, 92% and 88.4% for groups I, II and III respectively. On subgroup analysis, group III required ancillary treatments in 70% of patients whereas group I, II, did not require any ancillary treatments. On multivariate analysis, stone multiplicity, stone location (lower calyceal stones) and HU were independent significant predictors for the need for ancillary treatments after SWL (p values < 0.05).
Conclusions: Patients with stone attenuation value (HU) > 1000, multiple stones and/or lower calyceal stones have higher risk to necessitate ancillary treatments after SWL. These patients would likely benefit from upfront endoscopic lithotripsy for treating symptomatic renal or upper ureteral stones.
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| first_indexed | 2024-04-11T04:41:58Z |
| format | Article |
| id | doaj.art-19c484e6eb8b459a818d47e37dd52ea9 |
| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-04-11T04:41:58Z |
| publishDate | 2022-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-19c484e6eb8b459a818d47e37dd52ea92022-12-27T22:38:31ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972022-12-0194410.4081/aiua.2022.4.439Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones?Ahmed Ibrahim0Adel Elatreisy1Abdulghani Khogeer2Abdulsalam Ahmadi3Shashikant Mishra 4Mahmoud Faisal5Ravindra Sabnis 6Melanie Aube-Peterkin7Serge Carrier8Arvind Ganpule 9Mahesh Desai10Urology Department, Al-Azhar University, CairoUrology Department, Al-Azhar University, CairoDepartment of Surgery, Faculty of Medicine, Rabigh, King Abdulaziz University, JeddahMuljhibhai Patel Urological Hospital, NadiadMuljhibhai Patel Urological Hospital, NadiadUrology Department, Al-Azhar University, CairoMuljhibhai Patel Urological Hospital, NadiadDepartment of Surgery, Division of Urology, McGill University Health Center, Montreal QCDepartment of Surgery, Division of Urology, McGill University Health Center, Montreal QCMuljhibhai Patel Urological Hospital, NadiadMuljhibhai Patel Urological Hospital, Nadiad Objective: To quantify the predictors for the ancillary treatments after extracorporeal shock wave lithotripsy (SWL) for renal and upper ureteral stones. Materials and methods: From January 2014 to January 2017, patients undergoing SWL using an electromagnetic lithotripter machine (Compact Delta; Dornier MedTech GmbH, Wessling, Germany) for renal and upper ureteral stones ≤ 20 mm were retrospectively reviewed. All patients underwent CT urography prior to SWL. The cohort was subdivided into three groups according to stone attenuation values in Hounsfield Units (HU). Group I; HU < 500 (n = 20), group II; HU 500-1000 (n = 51) and group III; HU ≥ 1000 (n = 180). The parameters included for multivariate analysis were stone size, location, multiplicity, stone attenuation value, number of shocks and stone clearance rate by 3 months. The ancillary treatments were ureteroscopy (URS), ureteral stenting and hospital readmission for pain or fever. Results: A total of 251 patients were included in the study. The overall SWL success rate was 92.4%. Mean stone size was 10.9 ± 2.1, 11.6 ± 3 and 11.4 ± 3.6 mm and mean stone attenuation values were 364 ± 125, 811 ± 154 and 1285 ± 171 HU for groups I, II and III respectively. The stone clearance rates by 3 months were 96%, 92% and 88.4% for groups I, II and III respectively. On subgroup analysis, group III required ancillary treatments in 70% of patients whereas group I, II, did not require any ancillary treatments. On multivariate analysis, stone multiplicity, stone location (lower calyceal stones) and HU were independent significant predictors for the need for ancillary treatments after SWL (p values < 0.05). Conclusions: Patients with stone attenuation value (HU) > 1000, multiple stones and/or lower calyceal stones have higher risk to necessitate ancillary treatments after SWL. These patients would likely benefit from upfront endoscopic lithotripsy for treating symptomatic renal or upper ureteral stones. https://www.pagepressjournals.org/index.php/aiua/article/view/11023SWLUrolithiasisLower pole calyx stonesancillary treatmentfragmentation |
| spellingShingle | Ahmed Ibrahim Adel Elatreisy Abdulghani Khogeer Abdulsalam Ahmadi Shashikant Mishra Mahmoud Faisal Ravindra Sabnis Melanie Aube-Peterkin Serge Carrier Arvind Ganpule Mahesh Desai Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? Archivio Italiano di Urologia e Andrologia SWL Urolithiasis Lower pole calyx stones ancillary treatment fragmentation |
| title | Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? |
| title_full | Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? |
| title_fullStr | Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? |
| title_full_unstemmed | Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? |
| title_short | Can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones? |
| title_sort | can we predict the ancillary treatments after extracorporeal shockwave lithotripsy for renal and upper ureteral stones |
| topic | SWL Urolithiasis Lower pole calyx stones ancillary treatment fragmentation |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/11023 |
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