Prognostic Factors of Success of Extracorporeal Shock Wave Lithotripsy 46 (ESWL) in The Treatment of Renal Stones.

Background: Renal calculi are common approximately 50% of patient between the ages of 30and 50 years. The development of endourological and extracorporeal lithotripsy techniques ledto an increasing number of options for the management of renal calculi. Objective: To define factors those have a significant impact on the success rate after extracorporealshock wave lithotripsy (ESWL) for treatment of renal stones. Materials and Methods: Between April 2008 & December 2008, 64 patients with single ormultiple radiopaque renal stones (::s;30mm) were treated with ESWL monotherapy using StortzModulith SLX-F2 lithotriptor.The results of treatment were evaluated after 3 months of followupTreatment success was defined as complete clearance of the stones or presence ofclinically insignificant residual fragments (::s;4mm).The results of treatment were correlated withthe patient characteristics (age, sex, body mass index) and stone features (size, site, nature &radio density). Results: At 3-months follow-up, the overall success rate is 76%. Among them, repeated ESWLsessions are required in 19 patients (53.9%). Post-ESWL complications are recorded in 8patients (12.5%). Using the x2 test, only three factors have a significant impact on the successrate, namely: stone site, size (the largest diameter of the stone), stone number & BMI (BodyMass Index). The success rate is highest for stones located in the upper calyx (15/15; 100%)and lowest for those located in the lower calyx (10/16; 62.5%) (p=.005). Stones with a largestdiameter ot s 15mm are associated with a success rate of 90.2% (37 /41), compared to 52.2%(12/23) for those with a diameter of >15mm (p=.001). The success rate is also higher forsingle stone (46/56; 82%) than multiple stones (3/8; 37.5%) (p=0.005).Patients with lowerBMI (<24) have a better success than higher BMI (>25) (p=0.01) Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted bystone size, location, number and patient BMI. Journal of Surgical Sciences (2016) Vol. 20 (2) :46-50

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Evaluation of Factors Influencing Outcome of Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Stone in Adult

Bangladesh Journal of Urology ◽

10.3329/bju.v22i2.50102 ◽

2020 ◽

Vol 22 (2) ◽

pp. 141-150

Author(s):

Md Abdur Rakib ◽

Md Shahidul Islam ◽

SM Shameem Waheed

Keyword(s):

Shock Wave ◽

Body Mass Index ◽

Success Rate ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Renal Stone ◽

Renal Stones ◽

Results Of Treatment ◽

Extracorporeal Shock Wave

Background: Renal stone disease is a common disorder with a prevalence ranging from 4-15% in different parts of the world. Modalities of kidney stone management includes drug therapy, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), Retrograde intrarenal surgery ureteroscopy (RIRS) and open surgery. ESWL is an acceptable technique and widely used because it is a non-invasive treatment and does not require anesthesia and usually done on an outpatient basis. Generally, ESWL is the treatment of choice for kidney stones <1 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50%-87%, depending on various factors. This study was conducted in order to evaluate thefactors affecting renal stones treatment by extracorporeal shock wave lithotripsy (ESWL).On the basis of different variables andfactors affecting the renal stones treatment by ESWL was evaluated. Objectives: To evaluate the factors affecting the outcome of Extracorporeal Shock Wave Lithotripsy (ESWL) in the treatment of renal stone in adults.To assess the success and failure rate by using ESWL for treatment of renal stone, to determine the effects of stone related factors to correlate the success rate with characteristics of the patients condition of the urinary tract and stone features; to observe the patient groups most likely to benefit from or fail an initial intervention with ESWL and to evaluate the post ESWL complications. Materials and methods: This is a prospective observational and analytical, hospital based study. Total 500 patients with single or multiple radio-opaque renal stones were treated with ESWL monotherapy using Siemens MODULARIS Variostarlithotriptor. This study was carried out inthe Department of Urology, Combined Military Hospital, Dhaka for a period of two years between 01 July 2015 to 31 July 2017. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<3mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density). Results: At 3-months follow-up, the overall success rate is 87.6%. Among them, repeated ESWL sessions were required in 266 patients (53.2%). Post-ESWL complications were recorded in 62 patients (12.4%). Using the chi-square test, only four factors have a significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (136/136; 100%) and lowest for those located in lower calyx 104/78; 75%) (p=0.001). Stone with a largest diameter of <10mm are associated with a success rate of 93.6% (307/328), compared to 76.2% (131/172) for those with a diameter of >10mm (p=0.001). The success rate was also higher for single stone (396/437; 90.6%) than multiple stones (42/63; 66.7%) (p=.001). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=.001). Other factors including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patients BMI. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.141-150

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Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy

Journal of Dhaka Medical College ◽

10.3329/jdmc.v27i1.38950 ◽

2018 ◽

Vol 27 (1) ◽

pp. 72-78

Author(s):

Abul Hasanat Muhammad Afzalul Haque ◽

Md Waliul Islam ◽

Humayun Kabir Kallol ◽

Md Shaful Alam Babul ◽

Muhammad Habibur Rahman ◽

...

Keyword(s):

Shock Wave ◽

Success Rate ◽

Shock Wave Lithotripsy ◽

Renal Stone ◽

Renal Stones ◽

Factors Affecting ◽

Results Of Treatment ◽

Extracorporeal Shock Wave ◽

Stone Treatment

ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors. Aim: This study was conducted to evaluate Factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL). Materials and methods: The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density). Results: At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/ 84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. Conclusion: The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 72-78

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Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy

Bangladesh Medical Journal ◽

10.3329/bmj.v46i2.40214 ◽

2019 ◽

Vol 46 (2) ◽

pp. 1-6

Author(s):

Abul Hasanat Muhammad Afzalul Haque ◽

Md Waliul Islam ◽

Humayun Kabir Kallol ◽

Md Shaful Alam Babul ◽

Muhammad Habibur Rahman

Keyword(s):

Shock Wave ◽

Success Rate ◽

Shock Wave Lithotripsy ◽

Renal Stone ◽

Renal Stones ◽

Factors Affecting ◽

Results Of Treatment ◽

Extracorporeal Shock Wave ◽

Stone Treatment

ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors. This study was conducted to evaluate factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL). The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number and radio density). At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI. Bangladesh Med J. 2017 May; 46 (2): 1-6

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Efficacy of Percutaneous Nephrolithotomy in the Treatment of Renal Calculi of 10 to 20 MM Size: A Comparison With Extracorporeal Shock Wave Lithotripsy

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49881 ◽

2020 ◽

Vol 21 (2) ◽

pp. 98-104

Author(s):

Muhammad Mahmud Alam ◽

Mohammad Rezaul Karim ◽

Mohammad Ohiduzzaman Khan ◽

Mohammad Mukhlesur Rahman ◽

Mahfuja Asma ◽

...

Keyword(s):

Shock Wave ◽

Percutaneous Nephrolithotomy ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Renal Stones ◽

Renal Calculi ◽

Post Procedure ◽

Extracorporeal Shock Wave ◽

Significant Difference

Background: Stones in the urinary tract is a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) is also widely applied. There is a trend of using ESWL for treatment of renal stones smaller than 1 cm and PCNL in those with stones greater than 2 cm. Nevertheless, no consensus regarding treatment of renal stones between 1 to 2 cm stones. The objective of this prospective study was to compare the results of ESWL and PCNL for treatment of 1 to 2 cm renal stones. Method : This is a quasi experimental study. This study was conducted to compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) in treating 10 to 20 mm sized renal stone among the Bangladeshi population. This prospective study conducted between the periods of September, 2011 to August, 2012 in the department of urology, Bangabandhu Sheikh Mujib medical university (BSMMU) Hospital. All the patients attending the urology outpatient clinic with 10 to 20mm renal calculi were the study population. A total of 70 subjects were enrolled for this study and they were equally divided into two groups so that each group had 35 subjects. The one group received PCNL whereas the other group received ESWL. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-15). Results: There is no statistically significant difference in regarding age, sex, stone side(lt. or rt.), the distribution of stone (upper, middle and lower calyx) and size between the groups (p>0.05). At 3 month follow up among the patients in ESWL group stone cleared and not cleared were 25(71.4%) and 10(28.6%) respectively and at 3 month follow up among the patients in PCNL group stone cleared and not cleared were 33(94.3%) and 2(5.7%)respectively. There is statistically significant difference in stone clearance rate at 3 month follow up between the groups (p<0.05). All patients in ESWL group developed post procedure haematuria 35(100.0%). Other post procedure complications among the ESWL group pain, fever and steinstrasse were 12(34.3%), 07(20.0%) and 03(08.6%) respectively. Common post procedure complications among the patients of PCNL group pain, haematuria and fever were 11(31.4%), 33(94.3%) and 13(37.1%) respectively. Other post procedure complications in PCNL group were vomiting (8.6%), urinary leakage (5.7%), wound infection (11.4%) and urinary cutaneous fistula (5.7%). There was no statistically significant difference post procedure pain, haematuria and fever between the groups (p>0.05), but statistically significant difference observed in steinstrasse and wound infection between the groups (p<0.05). Mean±SD of hospital stay among the patients of ESWL group and PCNL group was 1.37±0.65 and 4.34±1.43 days respectively. There is statistically significant difference in hospital stay between the groups (p<0.05). Conclusion: Though some specific complications which can be treated conservatively are more in PCNL group it may be concluded that the treatment with PCNL is better option than ESWL among the patients having renal calculi 10 to 20 mm. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.98-104

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