Shock wave lithotripsy for ureteral stones in elderly male patients

Halachmi, Sarel; Meretyk, Shimon

doi:10.1080/13685530600907985

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…This study involved investigating 170 patients with ureteral stones treated with SWL once, or repeatedly if stone fragmentation was insufficient, of whom 109 had proximal ureteral calculi with an average diameter of 11 mm. Moreover, Halachimi et al [11] reported that age has no effect on SFR after SWL for ureteral stones, with no significant differences in average stone diameter and SFRs between the younger and older patients, after investigating 238 patients with ureteral calculi treated by SWL who were classified into two age-groups (14-69 and 70-82 years) (mean stone size: 10 × 8 and 11 × 8 mm, respectively, overall SFRs: 91 % in both groups).…”

Section: Discussionmentioning

confidence: 97%

“…Age has no relationship with SWL treatment outcomes in cases of ureteral stones, although a negative relationship exists between patient age and SFR in cases of kidney calculi after SWL therapy [5,[9][10][11][12][13][14]. Although the underlying mechanisms remain unknown, it is suggested that sclerotic changes in renal parenchyma occur with aging, leading to increased acoustic impedance and poor fragmentation, and consequently low SFR after SWL therapy for kidney calculi [9,10,15].…”

Section: Introductionmentioning

confidence: 99%

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Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy

et al. 2015

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We investigated the effects of aging on the stone-free rate (SFR) after shock wave lithotripsy (SWL) for the treatment of proximal ureteral calculi. A total of 247 consecutive patients were retrospectively selected, classified into seven groups set at 10 year increments (from 20 to 90 years), and examined for SFR after SWL. According to our final analysis, 185 male and 62 female patients with an average age of 54.1 years had stones with a diameter of 11.5 mm and a density of 893.1 Hounsfield units. On average, SFR was 74.9 % at 3 months after 1.7 SWL sessions. SFR gradually reached ≥ 90 % for each age-group after 1.5-2 years. Median durations to achieve 50 % SFR were estimated to be 21 and 86 days for those in their 20 and 80 s, respectively. However, the difference between the two estimates was not significant (p = 0.064). The durations to achieve 50 % SFR for the other groups lay between these two estimates. Aging does not affect long-term SFR, but patients aged ≥ 80 years might experience delayed stone clearance within the first 12 months after SWL.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy

et al. 2015

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“…Early reports regarding the use of SWL in this patient group have considered the method as safe and effective [5], and these results have been reproduced by more recent papers [6,7]. However, the issue of the method's efficacy (particularly in terms of stone-free rates, SFR) has not been clarified.…”

Section: Discussionmentioning

confidence: 73%

“…Issues of relevance for this population have been identified in the past and contribute to the notion that geriatric stone patients should not be considered a mere extension of the younger lithiasis population [3,4]. Previous studies focusing on the effect of age on the success rates of SWL have led to conflicting results [5][6][7][8][9][10][11], and the issue of SWL efficacy in the elderly stone population remains to be clarified.…”

Section: Introductionmentioning

confidence: 97%

Is shock wave lithotripsy efficient for the elderly stone formers? Results of a matched-pair analysis

et al. 2011

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The aim of the study was to evaluate the impact of age on the efficacy of extracorporeal shock wave lithotripsy (SWL), in a comparative study based on the principles of matched-pair analysis. Over a period of 4 years, 2,311 patients were treated with SWL in a tertiary referral center. Patient and stone data were recorded in a prospective electronic database. Among these patients, 115 (4.97%) were older than 70 years of age and fulfilled the criteria for inclusion in the study (Group A). For the purposes of the comparative analysis, Group A patients were matched for gender and stone parameters (side, location of stone, and diameter ±2 mm) with a control group of patients under the age of 70 (Group B). Following matching, the patients' electronic medical records were reviewed, to identify SWL success rates at 3 months and McNemar's test was used to compare the efficacy of SWL between the two groups. Matching was possible in all cases. The results indicate that there were no statistically significant differences in the mean number of SWL sessions or in the mean number of impulses per session between the two groups. The overall stone clearance rate achieved by SWL alone was 71.3% for Group A and 73.9% for group B. Discordant pairs were found in 37 cases (in 17 pairs only patients in Group A became stone-free, while in 20 pairs only patients in Group B became stone-free). By using McNemar's test, the difference in stone clearance rates between the two groups was not found to be statistically significant (p = 0.742). A total of 22 patients (19.1%) in Group A and 17 patients (14.7%) in Group B underwent an adjuvant procedure to achieve stone clearance. McNemar's test also revealed the absence of any statistically significant difference in SWL success rates between older and younger patients in the subgroups of patients presenting with either ureteric or renal stones (p = 0.727 and p = 0.571, respectively). In conclusion, SWL is still considered one of the first-line tools for geriatric patients suffering from urolithiasis, as increased age alone does not seem to adversely affect the efficacy of SWL.

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“…A study by Kimura and Sasagawa8 showed that younger age and small stone size were prognostic factors determining better stone clearance. However, another study by Halachmi and Meretyk also showed that patients’ age was not a predicting factor for ureteral stone clearance 9. Abdel-Khalek et al reported that renal and ureteral stones ≤1 cm in size were associated with a higher stone-free rate compared with those >1 cm in size.…”

Section: Discussionmentioning

confidence: 99%

Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients

Chen¹,

Lin²,

Lee³

et al. 2017

CIA

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BackgroundThis study compared the clinical outcomes of extracorporeal shock wave lithotripsy between elderly (aged $65 years) and non-elderly (aged <65 years) patients.MethodsA retrospective review of medical records was performed on 483 (non-elderly: 245, elderly: 238) patients with upper urinary tract stones who underwent shock wave lithotripsy between 2007 and 2015. The demographic data, stone parameters, stone-free rate, retreatment rate, and complication rate were analyzed in both elderly and non-elderly patient groups.ResultsThere was no significant difference between non-elderly and elderly patients in terms of stone-free rate (46.5% vs 41.1%, P>0.05) regardless of stone site or stone size and overall retreatment rate (41.6% vs 37.0%, P>0.05). Elderly patients had a higher complication rate than non-elderly patients (15.5% vs 23.5%, P=0.026). The most common complication was flank pain. Receiver operating characteristic curves predicted that elderly patients (cutoff value: 65 years of age) had a higher risk of complications and that patients with smaller stones (cutoff value: 0.8 cm) had a higher stone-free rate.ConclusionThis study showed that elderly patients with upper urinary tract stones undergoing shock wave lithotripsy had comparable efficacy for stone-free rates and retreatment rates, but higher complication rates.

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Shock wave lithotripsy for ureteral stones in elderly male patients

Abstract: Age itself has no effect on the success rate of SWL with the HM3 lithotripter for ureteral stones. In general, SWL treatment showed a high success rate with minimal morbidity and no treatment-related mortality.

Cited by 13 publications

References 16 publications

Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy

Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy

Is shock wave lithotripsy efficient for the elderly stone formers? Results of a matched-pair analysis

Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients

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