scholarly journals Prognostic Factors for the Effectiveness of Extracorporeal Shock Wave Lithotripsy in Patients with Ureterolithiasis

2021 ◽  
Vol 6 (6) ◽  
pp. 107-111
Author(s):  
S. M. Kolupayev ◽  
◽  
N. M. Andonieva ◽  
G. V. Lisova

The purpose of the work was to study prognostic factors for the effectiveness of extracorporeal shock wave lithotripsy in patients with ureterolithiasis. Materials and methods. The study included 53 patients with ureteral stones up to 2 cm in size. All patients underwent extracorporeal shock wave lithotripsy under ultrasound control, with a pulse rate of 90 per minute and a maximum number of pulses of 2000 per session. The outcome of treatment was evaluated by ultrasound on day 5 after the extracorporeal shock wave lithotripsy session. If there were stone fragments larger than 5 mm, a second extracorporeal shock wave lithotripsy session was performed. Treatment was considered effective in the absence of stone fragments in the urinary tract 4 weeks after extracorporeal shock wave lithotripsy. Results and discussion. The data were analyzed to identify clinical and radiological factors associated with treatment failure. As a result of the treatment, 46 (86.4%) patients were found to have no stones in the urinary tract (the condition is “stone free”), 9 (13.6%) had stone fragments larger than 5 mm 4 weeks after extracorporeal shock wave lithotripsy, and therefore contact ureterolithotripsy was performed. As complications, 7 (13.2%) patients had an exacerbation of chronic pyelonephritis, which required percutaneous nephrostomy. As the results showed, age, gender, body mass index, and Hausfield units did not differ significantly in terms of extracorporeal shock wave lithotripsy results. Factors that significantly affected the prognosis of extracorporeal shock wave lithotripsy success were the size of the stone and skin-stone distance. Body mass index did not significantly affect the outcome of lithotripsy in this study. The stone density index according to computed tomography data is considered by many authors to be a predictor of the effectiveness of fragmentation, but in our study this indicator was not a significant predictor of the effectiveness of extracorporeal shock wave lithotripsy, which allows us to think that there are other factors, namely the features of the internal structure of the stone, which determine its compliance with the shock wave. Conclusion. The size of the stone and the skin-stone distance are prognostic factors that affect the effectiveness of extracorporeal shock wave lithotripsy in patients with ureterolithiasis. Body mass index and stone density in Hausfield units did not significantly affect extracorporeal shock wave lithotripsy outcome in this study

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 103-105
Author(s):  
F. Merlo ◽  
E. Cicerello ◽  
P. Checchin ◽  
L. Faggiano ◽  
G. Anselmo

— The aim of this work has been to check the frequency and to assess which manoeuvres are necessary in treating the steinstrasse after ESWL. 1779 patients (1360 with renal and 419 with ureteral stones) underwent in-situ ESWL. 68 patients developed a steinstrasse in the immediate 24 hours following treatment. In 85% of the cases (58/68) there was dilation of the urinary tract. In 39 patients the steinstrasse was spontaneously eliminated within 10 days, while in the remaning 29 an auxiliary manoeuvre was necessary. These manoeuvres required further admittance to hospital or prolungation of stay, but created no statistically significant differences in the stone free rate 2 months after treatment (96 and 97% respectively, p< 0.001). Our experience would indicate that the incidence of steinstrasse after ESWL in situ is quite low (3.8%) and the necessity for auxiliary manoeuvres is extremely rare (1.6%).


1997 ◽  
Vol 64 (1) ◽  
pp. 37-39
Author(s):  
A. Parma ◽  
C. Bondavalli ◽  
C. Pegoraro ◽  
L. Schiavon ◽  
B. Dall'Oglio ◽  
...  

Technological developments in ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) have changed the treatment of ureteral stones over the last decade. “In situ” ESWL is now the treatment of choice in the management of ureteral calculi. Ureterolithotripsy should be preferred in certain cases, however, especially when the stone cannot be perfectly sighted or when the urinary tract needs to be drained due to obstruction and/or sepsis, with a saving of one ESWL session in 50% of patients. Current options that can be applied with lithotripsy are: electrohydraulic, laser, ultrasound and ballistic tripsy. The authors describe their experience with the Lithoclast in 82 patients. This technique has proved to be simple, safe, effective and particularly economic.


2019 ◽  
Vol 8 (3) ◽  
pp. 221-224
Author(s):  
Faramarz Mohammad Ali Beigi ◽  
Zahra Keivani Hafshejani ◽  
Mohammadreza Aghahoseini ◽  
Majid Shirani

Introduction: Extracorporeal shock wave lithotripsy (ESWL) is known as the most common method in treating urinary stones (70%) and is a selective method to treat small urinary stones (<2-2.5 cm). General opinion is that the success rate of ESWL in obese patients is low and risk of complications is high. Objectives: The aim of this study was to evaluate the impact of body mass index (BMI) and the stone-to-skin distance on success, complications and failure of ESWL. Patients and Methods: In this study, 222 patients who referred to lithotripsy clinic of Kashani hospital of Shahrekord to break stones with diameters of 5 to 20 mm participated in the study. Their urinary stones were in kidneys, lower calyces, upper calyces, pelvis or proximal ureter and were divided into two equal groups of BMI >25 kg/m2 and BMI <25 kg/m2 . Assessing the position and diameter of the stones was based on radiographic findings such as sonography and CT scan. Regarding success, failure and complications of lithotripsy, two groups were compared. Results: Around 105 and 117 patients out of 222 subjects, were respectively assigned in BMI>25 kg/ m2 and BMI <25 kg/m2 groups. The failure and success of both groups were statistically significant (P=0.023). In terms of treatment outcomes, difference between two groups was high in low skinto-stone distance (SSD). Logistic regression showed that both BMI and SSD are effective factors in treating the stone while SSD was more effective (P=0.004) than BMI (P=0.023) since SSD>7.5 cm predicts treatment failure. Conclusion: BMI and SSD are effective factors on the outcome of ESWL. Higher BMI and SSD> 7.5 cm are effective factors on treatment failure.


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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