Evaluation of Hounsfield Units as a predictive factor for the outcome of extracorporeal shock wave lithotripsy and stone composition

Urolithiasis ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Takehiko Nakasato ◽  
Jun Morita ◽  
Yoshio Ogawa
2020 ◽  
Vol 56 (2) ◽  
pp. 127
Author(s):  
Zuhri Sawal ◽  
Doddy M Soebadi

This study aimed to determine the impact of stone size, location and stone composition the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the management of residual stone after percutaneous nephrolithotomy (PCNL). The design of this study was a retrospective that conducted between January 2012 until December 2016. The population in this study were all patients with residual stones post PCNL. Exclusion criteria were patients with multiple stones and patients with a history of previous treatment for residual stones such as nephroscopy, flexible ureterorenoscopy, ESWL or medical therapy). The variables studied in this study were stone size, stone location, and stone composition. Before ESWL was carried out, all patients underwent Kidney Ureter Bladder (KUB). After ESWL, all patients underwent ultrasonography (USG) and KUB to determine the stone clearance status. The sample of this study was 125 patients. The overall stone-free rate (SFR) of ESWL in managing post-PCNL residual stones is 72%. SFR based on stone size variable are 73.7% and 71.3% respectively for stones with a size = 5 mm and >5 mm (p = 0.78). SFR based on stone location variable was 67.1%, 75.8%, and 81.8% respectively for the residual stone located at the upper pole, middle pole and lower pole. There are no significant differences in the entire variable. This study concludes that ESWL can be used as effective additional management to treat post-PCNL residual stones with satisfactory SFR.


2018 ◽  
Vol 86 (2) ◽  
pp. 63-68
Author(s):  
Peter Vitalevich Glybochko ◽  
Yuri Gennadevich Alyaev ◽  
Vadim Igorevich Rudenko ◽  
Leonid Mikhailovich Rapoport ◽  
Vagarshak Aramaisovich Grigoryan ◽  
...  

Aim: To evaluate the clinical efficiency of computed tomography for diagnostics of patients with urolithiasis and the choice of treatment strategy. Material and methods: The study was carried out at the Urological Clinic of I.M. Sechenov First Moscow State Medical University and included 1044 patients with urinary stones. The ultimate goal of this study was to predict the clinical efficiency of extracorporeal shock wave lithotripsy using a combination of computed tomography and densitometry. Extracorporeal shock wave lithotripsy was performed on “Siemens Lithostar Plus,” “Siemens Modularis Uro,” and “Dornier Gemini” lithotripters. Statistical analysis of clinical data included evaluation of individual sampling groups and calculation of weighted arithmetic mean ( M). Results: The efficiency of extracorporeal shock wave lithotripsy has been determined primarily using X-ray analysis of the concrement outlines and the structure (homogeneous or heterogeneous) of its central zone. However, in terms of efficiency and repetition rate (the number of fragmentation procedures required for complete clearance) of extracorporeal shock wave lithotripsy, the mean density of the concrement along the whole length of its three-dimensional structure (expressed in Hounsfield units) appeared to be the most reliable and informative predictive index in this study. Conclusion: The combination of computed tomography with densitometry in the treatment of patients with urolithiasis allows one (1) to determine the exact localization, size, X-ray structure, and structural density of urinary stones and (2) to predict, on the basis of densitometric data histograms, the clinical efficiency and repetition rate of extracorporeal shock wave lithotripsy with due regard to the X-ray structure of peripheral and central zones, and mean density (in Hounsfield units) of urinary concrements.


Urology ◽  
2005 ◽  
Vol 65 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Gyan Pareek ◽  
Noel A. Armenakas ◽  
Georgia Panagopoulos ◽  
John J. Bruno ◽  
John A. Fracchia

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