The efficacy of extracorporeal shockwave lithotripsy for symptomatic ureteral stones: Predictors of treatment failure without the assistance of computed tomography

Abstract

ObjectivesNon-contrast computed tomography (NCCT) is not always performed clinically if the diagnosis of ureteral calculi has been confirmed using other radiographic imaging modalities. The aim of this study was to identify predictors of successful extracorporeal shockwave lithotripsy (ESWL) without assistance of NCCT.MethodsWe retrospectively reviewed the medical records of patients with symptomatic solitary ureteral stones who underwent ESWL between November 2015 and January 2016. Abdominal plain radiography or intravenous urography were performed before ESWL for localization. The exclusion criteria were repeated sessions of ESWL for the target stone and congenital genitourinary tract anomalies. The demographic characteristics, clinical history, medical charges, or imaging features of the stones were recorded. Successful treatment was defined as no fragments detected on radiography or ultrasonography in 4 weeks. For radiolucent calculi, successful treatment was regarded as cases without hydronephrosis, symptoms, or hematuria. Patients experiencing intractable pain and undergoing subsequent auxiliary surgeries were regarded as having ESWL treatment failure.ResultsAge (odds ratio [OR], 1.042; 95% confidence interval [CI], 1.007–1.078), history of ipsilateral renal or ureteral calculi episodes (OR, 2.669; 95% CI, 1.281–5.687), stone burden (OR, 3.499; 95% CI, 1.284–9.530), and radiopaque stone (OR, 2.351; 95% CI, 1.049–5.267) were significant predictors of ESWL failure in all patients.ConclusionsFor treating symptomatic ureteral stones, those with smaller size, radiolucency, and without a history of ipsilateral renal or ureteral calculi could be considered for first-line therapy with ESWL.

Reduction of pre-procedural anxiety for repeat sessions in extracorporeal shockwave lithotripsy (ESWL) reduces pain intensity: A prospective observational study

“…[ 2 ] Hence, as fats have few sensory endings, tissue damage due to passage of shockwave is less likely to produce more pain than muscular participants. Radiolucent stones were analyzed as they were hypothesized [ 24 , 25 ] to predict higher pain scores due to difficulty to localize and focus the ESWL beam but there was no difference seen in this study between radiolucent and radiopaque stones. Patients who had pre-stenting due to presence of larger stones or potentially obstructing stones were also not significantly associated with higher pain score.…”

Stone decision engine accurately predicts stone removal and treatment complications for shock wave lithotripsy and laser ureterorenoscopy patients

“…Previous studies have shown SWL variables affecting treatment outcomes include gender [ 39 – 42 ], age [ 39 , 42 – 44 ], SSD [ 40 , 45 – 50 ], BMI [ 39 , 50 ], stone number [ 39 , 42 , 43 ], stone size [ 39 – 43 , 46 , 47 , 50 – 56 ], stone location [ 39 , 41 – 43 , 48 , 51 , 52 , 56 , 57 ], and stone characteristics [ 33 – 48 , 51 , 54 – 58 ]. Variables affecting URS outcomes include stone number [ 59 , 60 ], stone size [ 53 , 59 ], stone location [ 59 , 60 ], and stone characteristics [ 59 , 60 ].…”

Auxiliary Diagnosis of Hydronephrosis Based on Ultrasound Image Dynamic Enhancement Technique

“…Compared with other examination methods, MRU has the advantages of safe, non-radiative, easy to operate, noninvasive, non-contrast allergy, etc., and the patient's urine can be used as a natural contrast agent, and it is still applicable when the child has renal damage. In addition, clinicians can obtain clear and intuitive images as well as multi-plane and multi-angle observations and 3D reconstruction of the original image [5]. Moreover, the use of 99mTc-DTPA diagnostic method can not only diagnose hydronephrosis in children, but also evaluate the renal function of children by quantitative glomerular filtration rate, which has great application significance and value in clinical [6].…”