Does the degree of stone-induced hydronephrosis affect the outcome of shock-wave lithotripsy in patients with proximal ureteral stones?

Abuelnaga, Mahmoud; Alsadoun, Lara

doi:10.4103/ejs.ejs_227_19

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“…On the contrary, Abuelnaga et al . reported that the degree of hydronephrosis secondary to proximal ureteral stones did not affect the overall treatment success following SWL, a finding compatible with this study 16 . Similarly, another study by Demirbas et al .…”

Section: Discussionsupporting

confidence: 91%

“…15 On the contrary, Abuelnaga et al reported that the degree of hydronephrosis secondary to proximal ureteral stones did not affect the overall treatment success following SWL, a finding compatible with this study. 16 Similarly, another study by Demirbas et al showed that the degree of urinary obstruction caused by the stone did not affect the success rate of stone clearance with SWL. 17 It is reported that impacted ureteral stones respond poorly to SWL; however, the definition of stone impaction varies across studies.…”

Section: Discussionmentioning

confidence: 92%

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Efficacy of intravenous hydration during extracorporeal shock wave lithotripsy in improving ureteral stone treatment success rate

et al. 2022

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Objective The treatment efficacy of extracorporeal shock wave lithotripsy for urolithiasis depends on several factors. We aimed to evaluate the impact of intravenous hydration during shock wave lithotripsy on stone treatment success rate in patients with ureteral stones. Methods We retrospectively evaluated patients with ureteral stones <2 cm in diameter treated with extracorporeal shock wave lithotripsy at two sites. Patients from one of the sites received intravenous hydration with 500 mL of 0.9% NaCl. Stone treatment success status was defined as stone‐free or residual ureteral stones <0.4 cm in diameter 1 month after the procedure. Predictive factors associated with treatment success were evaluated using univariate and multivariate logistic regression. Results Overall, 146 consecutive patients with ureteral stones were included. Eighty (54.8%) patients received intravenous hydration. The overall stone treatment success rate was 66.4%. Those with intravenous hydration during the shock wave lithotripsy had significantly smaller stone size, lower serum creatinine levels, lower rate of alpha‐blockers use, and higher rate of nonsteroidal anti‐inflammatory drug use. Upon multivariate analysis, stone treatment success status postprocedure was significantly associated with stone size (odds ratio 4.118, 95% confidence interval 1.920–8.832, P < 0.0001) and intravenous hydration during the procedure (odds ratio 2.475, 95% confidence interval 1.176–5.208, P = 0.017). Conclusion Besides small ureteral stone size, concomitant intravenous hydration with 500 mL of normal saline during extracorporeal shock wave lithotripsy was significantly associated with subsequent stone passage. Administering 0.9% NaCl may be a simple and effective measure to improve the treatment efficacy of extracorporeal shock wave lithotripsy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 92%