A Prospective Evaluation of High-Resolution CT Parameters in Predicting Extracorporeal Shockwave Lithotripsy Success for Upper Urinary Tract Calculi

Abdel‐Hamid, Mona; Mosharafa, Ashraf A.; Ibrahim, Hamdy; Selim, Hany M; Hamed, Mohamed; Elghoneimy, Mohamed; Salem, Heba M.; Abdel-Azim, Mohamed; Badawy, Hesham

doi:10.1089/end.2016.0364

Cited by 26 publications

(22 citation statements)

References 19 publications

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“…3,8,12,13 The reported SFR in patients with stones >1000 HU ranged from 38 to 54.5%. 8,12,13 Thus, we excluded patients with BMI >30 kg/m 2 or SSD >11 cm in addition to other exclusion criteria to limit the adverse prognostic factors for SWL success to only high SAV. In contrast, we increased the cut-off of stone size up to 3 cm to check the efficacy of the SWL protocol used on this size.…”

Section: Resultsmentioning

confidence: 99%

“…SAV is also an important factor predicting SWL success. The cut‐off was variable in different studies, but was mostly approximately 1000 HU . The reported SFR in patients with stones >1000 HU ranged from 38 to 54.5% .…”

Section: Discussionmentioning

confidence: 99%

“…The cut‐off was variable in different studies, but was mostly approximately 1000 HU . The reported SFR in patients with stones >1000 HU ranged from 38 to 54.5% . Thus, we excluded patients with BMI >30 kg/m 2 or SSD >11 cm in addition to other exclusion criteria to limit the adverse prognostic factors for SWL success to only high SAV.…”

Section: Discussionmentioning

confidence: 99%

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Ultraslow full‐power shock wave lithotripsy versus slow power‐ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study

et al. 2019

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Objectives To compare the efficacy and safety of ultraslow full‐power versus slow rate, power‐ramping shock wave lithotripsy in the management of stones with a high attenuation value. Methods This was a randomized comparative study enrolling patients with single high attenuation value (≥1000 Hounsfield unit) stones (≤3 cm) between September 2015 and May 2018. Patients with skin‐to‐stone distance >11 cm or body mass index >30 kg/m2 were excluded. Electrohydraulic shock wave lithotripsy was carried out at rate of 30 shock waves/min for group A versus 60 shock waves/min for group B. In group A, power ramping was from 6 to 18 kV for 100 shock waves, then a safety pause for 2 min, followed by ramping 18–22 kV for 100 shock waves, then a safety pause for 2 min. This full power (22 kV) was maintained until the end of the session. In group B, power ramping was carried out with an increase of 4 kV each 500 shock waves, then maintained on 22 kV in the last 1000–1500 shock waves. Follow up was carried out up to 3 months after the last session. Perioperative data were compared, including the stone free rate (as a primary outcome) and complications (secondary outcome). Predicting factors for success were analyzed using logistic regression. Results A total of 100 patients in group A and 96 patients in group B were included. The stone‐free rate was significantly higher in group A (76% vs 38.5%; P < 0.001). Both groups were comparable in complication rates (20% vs 19.8%; P = 0.971). The stone‐free rate remained significantly higher in group A in logistic regression analysis (odds ratio 24.011, 95% confidence interval 8.29–69.54; P < 0.001). Conclusions Ultraslow full‐power shock wave lithotripsy for high attenuation value stones is associated with an improved stone‐free rate without affecting safety. Further validation studies are required using other shock wave lithotripsy machines.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultraslow full‐power shock wave lithotripsy versus slow power‐ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study

et al. 2019

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“…For SWL, factors affecting the SFR include stone density and skin‐to‐stone distance values The stone density can be measured using HU. Clinical algorithms for the prediction of upper ureteric stone and renal stones, such as the Triple D scoring system, have been developed to define the most appropriate cases for SWL application For PCNL, Okunov et al .…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…Commentary SWL might be considered as the first treatment option for the index patient who has no contraindication for SWL, with stones sized <20 mm in general 151 or <10 mm for lower caliceal stones with favorable anatomy and composition (noncystine, non-calcium monohydrate stone or stone CT HU <1000; LE:4). 100,101,152 For a patient with contraindication for SWL, abnormal body habitat, hard stone or unfavorable renal anatomy, other treatment options should be considered. CQ 22.…”

Section: Commentarymentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Setthawong

Srisubat

Potisat

et al. 2023

Cochrane Database of Systematic Reviews

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A Prospective Evaluation of High-Resolution CT Parameters in Predicting Extracorporeal Shockwave Lithotripsy Success for Upper Urinary Tract Calculi

Cited by 26 publications

References 19 publications

Ultraslow full‐power shock wave lithotripsy versus slow power‐ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study

Ultraslow full‐power shock wave lithotripsy versus slow power‐ramping shock wave lithotripsy in stones with high attenuation value: A randomized comparative study

The Urological Association of Asia clinical guideline for urinary stone disease

Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

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