Predicting Factors of the Success Rate of Extracorporeal Shock Wave Lithotripsy in Ureteral Stones: A Retrospective Evaluation with Large Patient Participiant

Abstract

Objective: In our retrospectively planned study; treated with ESWL method; we aimed to investigate the factors that predict the success of Extracorporeal Shock Wave Lithotripsy (ESWL) and its reliability in our patients with ureteral stones. Material and Methods: The study includes 489 patients treated for ureteral stones at Atatürk University Urology Clinic between 2008 and 2013. Patients underwent a maximum of three sessions of ESWL. Those who had fractures within two sessions were considered successful. Patients who underwent ESWL due to ureteral stones were retrospectively examined from hospital records. In predicting ESWL success, parameters such as gender, age, opacity, side and complication rates, and the need for additional procedures were evaluated. In patients who were stone-free after ESWL or had residual stones smaller than 4 mm on control imaging, ESWL was considered successful and stone-free was achieved. Sedoanalgesia was applied only to pediatric patients. Results: A total of 486 patients who underwent ESWL for ureteral stones were included in the study. The patients were divided into 3 groups according to age groups. Ages 1-18 were the first group, ages 20-40 were the second group, and people over 40 were the third group. Stone-free status was not statistically significant in terms of age groups and gender parameters. As a complication, stone street developed in 3 patients and hematuria developed in 2 patients. No significance was found between complications and the location of the stones (p=0.531). There was a significance between stone size and stone-free status and the development of complications (p=0.016, p=0.0001, respectively). Conclusion: It is essential to predict treatment success in ESWL and to protect patients from complications, time loss and morbidity that may arise from unnecessary treatment and procedures. In our study with large patient participation, we showed that ESWL is a method that can be safely preferred in ureteral stones with high success and low complication rates. In our study, stone size was found to be an important predictive value in predicting success.