Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience
Abstract. Background. Despite the continuous update of guidelines for the management of kidney stones, the ability to predict a successful response to extracorporeal shockwave lithotripsy (SWL) remains a topic of research. This is due to the need to refine the decision making in the context of techn...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2023-03-01
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| Series: | Current Urology |
| Online Access: | http://journals.lww.com/10.1097/CU9.0000000000000152 |
| _version_ | 1797690659332685824 |
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| author | Amr A. Faddan Osama Najieb Rabea A. Gadelkareem |
| author_facet | Amr A. Faddan Osama Najieb Rabea A. Gadelkareem |
| author_sort | Amr A. Faddan |
| collection | DOAJ |
| description | Abstract. Background. Despite the continuous update of guidelines for the management of kidney stones, the ability to predict a successful response to extracorporeal shockwave lithotripsy (SWL) remains a topic of research. This is due to the need to refine the decision making in the context of technological advancements and current pandemics. This study aimed to determine the predictors of stone-free rate (SFR) after single-session SWL in adult patients with a single kidney stone 10 to 20 mm in diameter.
Materials and methods. A retrospective review of the records of patients with a single kidney stone 10 to 20 mm in diameter was performed at a private SWL center from December 2019 to February 2021. Univariate and multivariate analyses were performed for stone- and patient-related factors, using the Student t and Mann-Whitney U tests for the quantitative variables and the Fisher exact and Pearson correlation tests for the qualitative variables.
Results. A total of 138 patients were eligible for this study, including 92 men and 46 women. The mean age was 38.6 ± 12.4 years, and the mean body mass index (BMI) was 25.9 ± 3.4 kg/m2. Four weeks after SWL, 120 patients (87%) were free of stones, and 18 (13%) needed further treatment. Univariate analyses showed that SFR was negatively correlated with increased BMI (p = 0.0001), maximum stone length (p = 0.0001), transverse diameter of the stone (p = 0.0001), number of shocks per session (p = 0.052), and Hounsfield unit (HU) (p = 0.0001). Multivariate analysis revealed that HU (p = 0.009), maximum stone length (p = 0.01), BMI (p = 0.000), and presence of double-J stent (p = 0.034) were independent risk factors for failure of single-session SWL in the treatment of kidney stones 10 to 20 mm in diameter. The estimated average cost per case was USD 450.5.
Conclusions. Increased HU, maximum stone length, BMI, and presence of double-J stents were independent risk factors for low SFR after single-session SWL for a kidney stone 10 to 20 mm in diameter. The cost of SWL remains an advantage in the private sector. |
| first_indexed | 2024-03-12T02:03:31Z |
| format | Article |
| id | doaj.art-b94cde01281041ff849888521595a0c2 |
| institution | Directory Open Access Journal |
| issn | 1661-7649 |
| language | English |
| last_indexed | 2024-03-12T02:03:31Z |
| publishDate | 2023-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Current Urology |
| spelling | doaj.art-b94cde01281041ff849888521595a0c22023-09-07T09:31:01ZengWolters Kluwer HealthCurrent Urology1661-76492023-03-01171303510.1097/CU9.0000000000000152202303000-00006Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experienceAmr A. Faddan0Osama Najieb1Rabea A. Gadelkareem2a Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egyptb Health Insurance Hospital, Ministry of Health, Mallawy, Egypta Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, EgyptAbstract. Background. Despite the continuous update of guidelines for the management of kidney stones, the ability to predict a successful response to extracorporeal shockwave lithotripsy (SWL) remains a topic of research. This is due to the need to refine the decision making in the context of technological advancements and current pandemics. This study aimed to determine the predictors of stone-free rate (SFR) after single-session SWL in adult patients with a single kidney stone 10 to 20 mm in diameter. Materials and methods. A retrospective review of the records of patients with a single kidney stone 10 to 20 mm in diameter was performed at a private SWL center from December 2019 to February 2021. Univariate and multivariate analyses were performed for stone- and patient-related factors, using the Student t and Mann-Whitney U tests for the quantitative variables and the Fisher exact and Pearson correlation tests for the qualitative variables. Results. A total of 138 patients were eligible for this study, including 92 men and 46 women. The mean age was 38.6 ± 12.4 years, and the mean body mass index (BMI) was 25.9 ± 3.4 kg/m2. Four weeks after SWL, 120 patients (87%) were free of stones, and 18 (13%) needed further treatment. Univariate analyses showed that SFR was negatively correlated with increased BMI (p = 0.0001), maximum stone length (p = 0.0001), transverse diameter of the stone (p = 0.0001), number of shocks per session (p = 0.052), and Hounsfield unit (HU) (p = 0.0001). Multivariate analysis revealed that HU (p = 0.009), maximum stone length (p = 0.01), BMI (p = 0.000), and presence of double-J stent (p = 0.034) were independent risk factors for failure of single-session SWL in the treatment of kidney stones 10 to 20 mm in diameter. The estimated average cost per case was USD 450.5. Conclusions. Increased HU, maximum stone length, BMI, and presence of double-J stents were independent risk factors for low SFR after single-session SWL for a kidney stone 10 to 20 mm in diameter. The cost of SWL remains an advantage in the private sector.http://journals.lww.com/10.1097/CU9.0000000000000152 |
| spellingShingle | Amr A. Faddan Osama Najieb Rabea A. Gadelkareem Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience Current Urology |
| title | Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience |
| title_full | Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience |
| title_fullStr | Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience |
| title_full_unstemmed | Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience |
| title_short | Predictors of stone-free rate after a single-session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm: A private center experience |
| title_sort | predictors of stone free rate after a single session extracorporeal shockwave lithotripsy for a single kidney stone measuring 10 to 20 mm a private center experience |
| url | http://journals.lww.com/10.1097/CU9.0000000000000152 |
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