scholarly journals ESWL EFFECTIVENESS FOR LOWER POLE KIDNEY STONES

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Riza Mazidu Sholihin ◽  
Soetojo Soetojo ◽  
Haviv Muris
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Clearance Rate ◽  
Kidney Stone ◽  
Lower Pole ◽  
Stone Size ◽  
Chi Square ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate

Objective: To describe the profile of lower pole kidney stone patients who underwent Extracorporeal Shock Wave Lithotripsy (ESWL) and the clearance rate of ESWL for lower pole kidney stones at Soetomo General Hospital from 2012 to 2016. Material & Methods: This research design was analytical retrospective, lower pole kidney stone patients who underwent ESWL in Soetomo General Hospital from 2012 to 2016 who fulfill inclusion criteria become samples in this research. Samples were divided into two group, stone size <15 mm and 15-20 mm. Results: Total samples in this study were 128, consist of 81 males and 47 females. The age average was 48 ± 11.124. The stone size average was 9.5 ± 4.5 mm consisted of 109 patients with stone size <15 mm and 19 patients with stone size 15-20 mm. There were 119 single lower pole kidney stones and 9 multiple ones. From all patients, 77 patients (60.2%) were stones free and the rest (39.8%) were not. Stone free rate for lower pole kidney stones was higher in stone size <15 mm compared with 15-20 mm, 65.2% and 31.5% respectively. Statistical analysis with Chi-square showed significant ESWL clearance rate difference between lower pole kidney stone size <15mm group and 15-20 mm (p<0.05). Conclusion: ESWL was a safe option for lower pole kidney stones with high success rate. There was significant relationship between stone size and stone clearance rate. ESWL was effective for lower pole kidney stones size <15 mm. 

scholarly journals Predictors of Success after Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Calculi Between 20—30 mm: A Multivariate Analysis Model

2006 ◽  
Vol 6 ◽  
pp. 2388-2395 ◽  
Author(s):  
Ahmed El-Assmy ◽  
Ahmed R. El-Nahas ◽  
Mohamed E. Abo-Elghar ◽  
Ibrahim Eraky ◽  
Mahmoud R. El-Kenawy ◽  
...  
Keyword(s):  
Surface Area ◽  
Renal Stones ◽  
Renal Calculi ◽  
Analysis Model ◽  
Stone Surface ◽  
Chi Square ◽  
Renal Anomalies ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Free Rate

The first-line management of renal stones between 20—30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups. Between January 1990 and January 2004, 594 patients with renal stones 20—30 mm in length underwent ESWL monotherapy. Stone surface area was measured for all stones. The results of treatment were evaluated after 3 months of follow-up. The stone-free rate was correlated with stone and patient characteristics using the Chi-square test; factors found to be significant were further analyzed using multivariate analysis.Repeat ESWL was needed in 56.9% of cases. Post-ESWL complications occurred in 5% of cases and post-ESWL secondary procedures were required in 5.9%. At 3-month follow-up, the overall stone-free rate was 77.2%. Using the Chi-square test, stone surface area, location, number, radiological renal picture, and congenital renal anomalies had a significant impact on the stone-free rate. Multivariate analysis excluded radiological renal picture from the logistic regression model while other factors maintained their statistically significant effect on success rate, indicating that they were independent predictors. A regression analysis model was designed to estimate the probability of stone-free status after ESWL. The sensitivity of the model was 97.4%, the specificity 90%, and the overall accuracy 95.6%.Stone surface area, location, number, and congenital renal anomalies are prognostic predictors determining stone clearance after ESWL of renal calculi of 20—30 mm. High probability of stone clearance is obtained with single stone ≤400 mm2 located in renal pelvis with no congenital anomalies. Our regression model can predict the probability of the success of ESWL in such controversial groups and can define patients who would need other treatment modality.

scholarly journals Quality of life of patients with kidney stones

2020 ◽  
Vol 10 (2) ◽  
pp. 115-124
Author(s):  
Vladimir V. Protoshchak ◽  
Mikhail V. Paronnikov ◽  
Aleksei A. Sivakov ◽  
Artem O. Kiselev
Keyword(s):  
Quality Of Life ◽  
Kidney Stones ◽  
Social Impact ◽  
Life Questionnaire ◽  
Stone Size ◽  
Factors Affecting ◽  
Extracorporeal Shock Wave ◽  
Sf 36 ◽  
Stone Free Rate

Relevance. In 2013, the Wisconsin Stone Quality of Life Questionnaire (WISQoL) was developed a specific tool for assessing the quality of life (QoL) in patients with urolithiasis. Aim. To determine the possibility of using the WISQoL and SF-36 questionnaires to study the treatment results of patients with kidney stones. Materials and methods. The study included 218 patients with nephrolithiasis. Patients were divided into 2 groups: the first the size of the stone up to 10 mm and the second from 11 to 20 mm. At the first stage, the efficacy of treatment patients by the extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolitholapaxy (PNL) 1 week, 1 and 3 months after surgery was compared. Questionnaires were used to study factors affecting the QOL of patients, including: gender, age, number, density and size of stones, hydronephrosis, stone free rate (SFR), type of surgery. At the next stage, the dynamics of changes in scores for the domains of questionnaires at different stages of treatment was evaluated. Results. The efficacy of treating kidney stones up to 1 cm in size after 3 months with ESWL was 86,1% and PNL 94,4 %, while stones up to 20 mm using ESWL 73,4% and percutaneous techniques 90,6%. Gender, age, stone size, SFR affected the QoL of patients with nephrolithiasis, while the number and density of stones, the presence of hydronephrosis and the type of operation were not significant. Patients 1 week after PNL had lower QoL scores in the domains of social impact and impact on vitalyty of WISQoL and mental heals of SF-36. After 1 month, these changes were determined only in the social impact domain and completely regressed by the 3rd month. Conclusion. SFR after ESWL and PNL in the first group is comparable, in the second group, percutaneous operations were 17,2% more effective. Male gender, age up to 40 years, stone size more than 1 cm, and also not reached SFR negatively affects patients with nephrolithiasis. Compared with ESWL and PNL is accompanied by the worst dynamics of QOL scores only 1 week after the operation; upon further observation, negative changes are leveled.

scholarly journals STONE FREE RATES OF KIDNEY STONE WAS LOWER THAN THE ONE OF URETER STONE PATIENTS MANAGED BY ESWL AND THE ONE OF URETER STONE MANAGED BY URETEROLITHOTRIPSY

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Zuhirman Zamzami
Keyword(s):  
Kidney Stones ◽  
Medical Records ◽  
Kidney Stone ◽  
Shockwave Lithotripsy ◽  
Ureter Stone ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Male Patients ◽  
The One ◽  
Free Rate

Objective: To evaluate the stone free rates of kidney and ureter stone patients managed by Extracorporeal Shockwave Lithotripsy (ESWL), and the ureter stone free rate managed by ureterolithotripsy. Material & method: We reviewed the medical records of kidney and ureter stone patients managed by ESWL and ureter stone patients managed by ureterolithotripsy in Arifin Achmad Regional General Hospital Pekanbaru Riau Province, Indonesia, from January 2010 - December 2016. ESWL and ureterolithotripsy stone free rates were examined by the control of KUB röngents. Results: There were 891 kidney and ureter stone patients consisting of 325 (36.5%) were kidney stone patients and 566 (63.5%) were ureter stone patients. The pyelum stones were the most (78.2%) in kidney stones and the lower ureter stones were the most (57.2%) in ureter stones. There were more male patients than the female ones in which most of the patients were in the group age of 49-59 years. The amount of patients increased each year. The kidney stone free rate managed by ESWL was lower (71.7%) than ureter stone free rate (84.1%) by ESWL, while the stone free rate of ureter stone patients managed by ureterolithotripsy was 100%. Conclusion: The ESWL stone free rate of the kidney stone patients was lower than the one in ureter stone patients while the ureterolithotripsy stone free rate was 100%.

scholarly journals COMPARISON OF STONE FREE RATE OF STAGHORN STONE, RENAL PELVIC STONE, AND INFERIOR CALYX STONE FOLLOWING PCNL

2016 ◽  
Vol 23 (1) ◽  
Author(s):  
Pande Made Wisnu Tirtayasa ◽  
Ponco Birowo ◽  
Nur Rasyid
Keyword(s):  
General Hospital ◽  
Kidney Stones ◽  
Medical Records ◽  
Incomplete Data ◽  
Inclusion Criteria ◽  
Stone Free Rate ◽  
Staghorn Stone ◽  
Free Rate ◽  
Free Status ◽  
Staghorn Stones

Objective: To compare the stone free rates on patients with staghorn, renal pelvic, and inferior calyx stones with stone burden < 20 mm, 21-30 mm, and > 30 mm following percutaneous nephrolithotomy (PCNL) in Cipto Mangunkusumo General Hospital Jakarta. Material & methods: The data were collected retrospectively from PCNL medical records in Cipto Mangunkusumo General Hospital Jakarta between January 2000 and March 2011. Six hundred and twenty-three patients with 651 kidney stones underwent PCNL. The inclusion criteria were staghorn stones, renal pelvic stone, and inferior calyx stone. All cases outside these three criteria and incomplete data were excluded. Stone free status was defined as no residual fragment on radiography or ultrasonography. Results: As many as 364 kidney stones from 344 patients were included, with 47.8% cases of staghorn stones, 31.9% cases of renal pelvic stones, and 20.3% cases of inferior calyx stones. Overall, 273 (75%) cases were defined as stone free. In group < 20 mm, 4 staghorn stones (100%), 18 renal pelvic stones (81.8%), and 34 inferior calyx stones (94.4%) were cleared (p = 0.811). In group 21-30 mm, 20 staghorn stones (95.2%), 52 renal pelvic stones (91.2%), and 26 inferior calyx stones (92.9%) were cleared (p = 1.000). In group > 30 mm, 83 staghorn stones (55.7%), 28 renal pelvic stones (75.7%), and 8 inferior calyx stones (80%) were cleared (p = 0.037). Conclusion: PCNL is an important tool for treating various kinds and sizes of kidney stones with high stone free rate.

scholarly journals Micropercutaneous Laser Lithotripsy: How to Improve Stone Free Rate

2020 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Kidney Stones ◽  
Laser Lithotripsy ◽  
Ureteral Access Sheath ◽  
Endoscopic Control ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Group A ◽  
Thulium Fiber Laser ◽  
Group B ◽  
Free Rate

Introduction: Micropercutaneous Nephrolithotomy is a novel technique with the creation of a 4.85-8F working channel. The advantage of micro-PCNL is the possibility of kidney puncture under direct endoscopic control. Materials and Methods: 99 patients aged 47,3 ± 16.9 years were included in the study. 78 patients had isolated kidney stones (78.8%). The stone size ranged from 8 to 38 mm (13.9 ± 5.4 mm). Group A included stones smaller than 15 mm (57 patients, 57,6%) and Group B included stones larger than 15 mm (42 patients, 42,4%). A 4.85 F percutaneous sheath was used in 38 (38,4%) patients, 8 F sheath was used in 61 (61,6%) patients. A holmium laser for lithotripsy was used in 46.5% cases, the thulium fiber laser in 53.5%. Results: The average surgery time was 39,9 ± 13.7 min (from 13 to 75 min). A stone-free rate (SFR) for patients of both groups was 88.8%. A Double-J stent was placed in 39 (39.4%) patients. In one case conversion to the mini-PCNL was done. In four cases (4%) retrograde stone manipulations were performed through ureteral access sheath. 5 (5.1%) patients required the second micro-PCNL tract. 3 (3%) patients required stenting postoperatively. In 7.1% of cases the episode of acute pyelonephritis developed. In 7 cases (7,1%), Extracorporeal Shock Wave Lithotripsy was required due to residual stones. Conclusions: We recommend using the laser micro-PCNL for the category of patients with severe comorbidities, including coagulopathy. The micro-PCNL could be safely performed in patients with kidney stones larger than 1.5 cm.

scholarly journals The effect of inclined position on stone free rates in patients with lower caliceal stones during SWL session

2015 ◽  
Vol 87 (1) ◽  
pp. 38
Author(s):  
Basri Cakiroglu ◽  
Orhun Sinanoglu ◽  
Tuncay Tas ◽  
Ismet Aydin Hazar ◽  
Mustafa Bahadir Can Balci
Keyword(s):  
Shock Wave ◽  
Urinary Bladder ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Lower Pole ◽  
Trendelenburg Position ◽  
Stone Size ◽  
Treatment Groups ◽  
Stone Free Rate ◽  
Free Rate

Objective: To compare the outcomes of shock wave lithotripsy (SWL) combined with inclined position and SWL alone in patients with lower pole calyx stones. Methods: Seven hundred forty patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. They were comparable in terms of age, sex, and stone diameters. Patients with lower calyceal stones (4-20 mm) were randomized to SWL (368 patients) or SWL with simultaneous inclination (372 patients) with 30o head down Trendelenburg position). Shock wave and session numbers were standardized according to stone size. Additional standardized shock waves were given to patients with stone fragments determined by kidney urinary bladder film and ultrasound at weeks 1, 4, 10. Results: The overall stone free rate (SFR) was 73% (268/368) in patients with SWL alone and 81% (300/372) in SWL with inclination at the end of 12th week (p = 0.015). No significant adverse events were noted in both treatment groups. Conclusion: Simultaneous inclination of patients during SWL session increase SFR in lower caliceal stones significantly compared to SWL treatment alone.

Inversion, Hydration and Diuresis during Extracorporeal Shock Wave Lithotripsy: Does It Improve the Stone-Free Rate for Lower Pole Stone Clearance?

2009 ◽  
Vol 83 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Stefanos Albanis ◽  
Hammad M. Ather ◽  
Athanasios G. Papatsoris ◽  
Junaid Masood ◽  
Dimitrios Staios ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Lower Pole ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Lower Pole Stone ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals COMPARISON OF S.T.O.N.E. SCORE AND GUY SCORE IN PREDICTING STONE FREE RATES OF PERCUTANEOUS NEPHROLITHOTOMY PROCEDURES IN THE SOETOMO GENERAL HOSPITAL

2021 ◽  
Vol 28 (1) ◽  
pp. 91-97
Author(s):  
I Dewa Gede Reza Sanjaya ◽  
Doddy M. Soebadi ◽  
Tarmono Djojodimedjo ◽  
Bambang Soeprijanto
Keyword(s):  
General Hospital ◽  
Strong Relationship ◽  
Inclusion Criteria ◽  
Stone Size ◽  
Relationship Strength ◽  
X Ray ◽  
Stone Free Rate ◽  
Size Evaluation ◽  
The Relationship ◽  
Free Rate

Objective: To determine the effectiveness of Modified Guy's Stone Score (GSS) and S.T.O.N.E score (SS) as predictors of stone free rates in patients undergoing PCNL. Material & Methods: The design of this study was a prospective observational analytic. Samples were patients with kidney stones who came to the Urology Polyclinic of Soetomo0 General Hospital Surabaya, which was planned to undergo PCNL surgery, patients who met the inclusion criteria will have a CT stonographic examination then counted for the S.T.O.N.E score and Modified Guy's Stone Score before the PCNL procedure. Postoperative stone size evaluation used KUB X-ray (BOF) to assess Stone Free Rate (SFR). Results: In the ETA statistical test there was a strong relationship between GSS and SFR with a relationship strength value of 0.609, the direction of the relationship between these two variables was positive. This means that the greater the GSS, the less likely the SFR could be achieved. The relationship between these two variables was significant with p= 0.05. While between SS and SFR with a relationship strength value of 0.55, the strength of the relationship in these two variables was positive which indicated the higher the SS, the less likely the occurrence of SFR. But both of them were not statistically significant with p= 0.228. Conclusion: Guy Stone Score (GSS) gives a better predictive value than the STONE score (SS) on the stone free rates in patients undergoing PCNL procedures.

scholarly journals Trends in Renal Stone Clearance after Ureteroscopy: A Review

2019 ◽  
Vol 2 (4) ◽  
pp. e44-e50
Author(s):  
Subiksha Subramonian ◽  
Somasundari Gopalakrishnan ◽  
Yuko Smith
Keyword(s):  
Ct Scan ◽  
Clearance Rate ◽  
Holmium Laser ◽  
Clearance Rates ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Stone Free Rate ◽  
Free Rate ◽  
Over Time

Background and ObjectivesStone clearance rate in ureteroscopy has varied over the years. This study aims to review the stone clear-ance rate over the last 25 years and assess the change over time. We have analyzed the reasons for the peaks and troughs in stone clearance rate to see if it correlates with any factors such as the introduction of new technology like the holmium laser, flexible ureteroscopy, access sheaths, and digital ureteroscopy. Material and MethodsWe performed a PubMed search (August 2019) for papers including the terms “lithiasis”, “stone clear-ance”, “calculi”, “kidney stone”, “ureteric stone”, “ureteroscopy”, “holmium laser”, “retrorenal surgery” in their title and published between the years 1994 and 2019. The stone size, stone clearance rate and mode of imaging to determine clearance rates were recorded. For data analysis, only prospective studies with a minimum of 50 patients and ureteroscopy arm of prospective randomized controlled trials were included. ResultsWe reviewed 16 papers with a total of 1,689 patients with renal stones. Average stone clearance was 80% and the median stone size was 11.0mm. Stone clearance was determined by either: Computed tomography (CT) scan (8 studies), x-ray alone (3 studies), x-ray and ultrasound (3 studies) or not mentioned (2 studies). CT scan yielded lower stone clearance rates than x-ray due to the increased detail shown on CT. For studies that used absolute clearance with no residual stones, average clearance was 52%, and this stone clearance rate increased as the cut-off size used to determine the stone-free rate was increased.ConclusionThis study highlights that stone clearance rate after ureteroscopy varies significantly amongst different pa-pers because of the stone size used to define ‘stone-free rate’ and the method of imaging used to determine stone clearance. The study also shows that stone clearance rates have not improved significantly over time, despite the introduction of advances in technology.

scholarly journals BODY MASS INDEX RELATIONS WITH THE DIFFICULTIES AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY

2016 ◽  
Vol 23 (2) ◽  
Author(s):  
Fauriski Febrian Prapiska ◽  
Sunaryo Hardjowijoto ◽  
Doddy M Soebadi ◽  
Tarmono Djojodimedjo
Keyword(s):  
Body Mass ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stone ◽  
Open Surgery ◽  
Stone Size ◽  
Stone Free Rate ◽  
Patients With Diabetes ◽  
Grade Ii ◽  
The Right ◽  
Free Rate

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p <0.05. CI 95%). However the lower stone free rate had significant effect (0.040. p <0.05. CI 95%).Conclusion: BMI had no significant effect with Intraoperative and postoperative difficulties in PCNL.However, the lower stone-free rate risk associated with elevated BMI was significant.

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