ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 13 of 45
Up
УЖМБС 2021, 6(6): 107–111
https://doi.org/10.26693/jmbs06.06.107
Clinical Medicine

Prognostic Factors for the Effectiveness of Extracorporeal Shock Wave Lithotripsy in Patients with Ureterolithiasis

Kolupayev S. M., Andonieva N. M., Lisova G. V.
Abstract

The purpose of the work was to study prognostic factors for the effectiveness of extracorporeal shock wave lithotripsy in patients with ureterolithiasis. Materials and methods. The study included 53 patients with ureteral stones up to 2 cm in size. All patients underwent extracorporeal shock wave lithotripsy under ultrasound control, with a pulse rate of 90 per minute and a maximum number of pulses of 2000 per session. The outcome of treatment was evaluated by ultrasound on day 5 after the extracorporeal shock wave lithotripsy session. If there were stone fragments larger than 5 mm, a second extracorporeal shock wave lithotripsy session was performed. Treatment was considered effective in the absence of stone fragments in the urinary tract 4 weeks after extracorporeal shock wave lithotripsy. Results and discussion. The data were analyzed to identify clinical and radiological factors associated with treatment failure. As a result of the treatment, 46 (86.4%) patients were found to have no stones in the urinary tract (the condition is “stone free”), 9 (13.6%) had stone fragments larger than 5 mm 4 weeks after extracorporeal shock wave lithotripsy, and therefore contact ureterolithotripsy was performed. As complications, 7 (13.2%) patients had an exacerbation of chronic pyelonephritis, which required percutaneous nephrostomy. As the results showed, age, gender, body mass index, and Hausfield units did not differ significantly in terms of extracorporeal shock wave lithotripsy results. Factors that significantly affected the prognosis of extracorporeal shock wave lithotripsy success were the size of the stone and skin-stone distance. Body mass index did not significantly affect the outcome of lithotripsy in this study. The stone density index according to computed tomography data is considered by many authors to be a predictor of the effectiveness of fragmentation, but in our study this indicator was not a significant predictor of the effectiveness of extracorporeal shock wave lithotripsy, which allows us to think that there are other factors, namely the features of the internal structure of the stone, which determine its compliance with the shock wave. Conclusion. The size of the stone and the skin-stone distance are prognostic factors that affect the effectiveness of extracorporeal shock wave lithotripsy in patients with ureterolithiasis. Body mass index and stone density in Hausfield units did not significantly affect extracorporeal shock wave lithotripsy outcome in this study

Keywords: urolithiasis, extracorporeal shock wave lithotripsy, ureteral stones, prognostic factors

Full text: PDF (Ukr) 294K

References
  1. Turk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K, et al. EAU Guidelines on Urolithiasis. Edn presented at the EAU Annual Congress, Amsterdam 2020. Available from: https://uroweb.org/guideline/urolithiasis
  2. Joshi HN , Shrestha B , Karmacharya RM , Makaju S , Koju R , Gyawali D. Management of Proximal Ureteric Stones: Extracorporeal Shock Wave Lithotripsy (ESWL) Versus Ureterorenoscopic Lithotripsy (URSL). Kathmandu Univ Med J (KUMJ). 2017 Oct-Dec;15(60):343-346. https://www.ncbi.nlm.nih.gov/pubmed/30580354
  3. Cui X, Ji F, Yan H, Ou TW, Jia CS, He XZ, et al. Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis. Urology. 2015 Apr;85(4):748-56. https://www.ncbi.nlm.nih.gov/pubmed/25681251. https://doi.org/10.1016/j.urology.2014.11.041
  4. Al-Marhoon MS, Shareef O, Al-Habsi IS, Al Balushi AS, Mathew J, Venkiteswaran KP. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital. Oman Med J. 2013;28(4):255‐259. https://www.ncbi.nlm.nih.gov/pubmed/23904918. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3725239. https://doi.org/10.5001/omj.2013.72
  5. Hassouna ME, Oraby S, Sameh W, El-Abbady A. Clinical experience with shock-wave lithotripsy using the Siemens Modularis Vario lithotripter. Arab J Urol. 2011 Jun;9(2):101-5. https://www.ncbi.nlm.nih.gov/pubmed/26579276. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4150585. https://doi.org/10.1016/j.aju.2011.06.004
  6. D'Addessi A, Vittori M, Racioppi M, Pinto F, Sacco E, Bassi P. Complications of extracorporeal shock wave lithotripsy for urinary stones: to know and to manage them-a review. Sci World J. 2012;2012:619820. https://www.ncbi.nlm.nih.gov/pubmed/22489195. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3317539. https://doi.org/10.1100/2012/619820
  7. World Health Organization. BMI classification. Available from: http://www.assessmentpsychology.com/icbmi.htm. Accessed December 06, 2021
  8. Chung DY, Cho KS, Lee DH, Han JH, Kang DH, Jung HD, et al. Impact of colic pain as a significant factor for predicting the stone free rate of one-session shock wave lithotripsy for treating ureter stones: a Bayesian logistic regression model analysis. PLoS One. 2015;10(4):e0123800. https://www.ncbi.nlm.nih.gov/pubmed/25902059. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4406693. https://doi.org/10.1371/journal.pone.0123800
  9. Chaussy C, Schmiedt E, Jocham D, Brendel W, Forssmann B, Walther V. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol. 1982 Mar;127(3):417-20. https://www.ncbi.nlm.nih.gov/pubmed/6977650. https://doi.org/10.1016/s0022-5347(17)53841-0
  10. Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int. 2005 Jun;95(9):1285-8. https://www.ncbi.nlm.nih.gov/pubmed/15892818. https://doi.org/10.1111/j.1464-410X.2005.05520.x
  11. Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA. Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology. 2005 Jan;65(1):33-6. https://www.ncbi.nlm.nih.gov/pubmed/15667858. https://doi.org/10.1016/j.urology.2004.08.004
  12. Choi JW, Song PH, Kim HT. Predictive factors of the outcome of extracorporeal shockwave lithotripsy for ureteral stones. Korean J Urol. 2012;53(6):424-430. https://www.ncbi.nlm.nih.gov/pubmed/22741053. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3382694. https://doi.org/10.4111/kju.2012.53.6.424
  13. Hatiboglu G, Popeneciu V, Kurosch M, Huber J, Pahernik S, Pfitzenmaier J, et al. Prognostic variables for shockwave lithotripsy (SWL) treatment success: no impact of body mass index (BMI) using a third generation lithotripter. BJU Int. 2011 Oct;108(7):1192-7. https://www.ncbi.nlm.nih.gov/pubmed/21342413. https://doi.org/10.1111/j.1464-410X.2010.10007.x
  14. Rush E, Plank L, Chandu V, Laulu M, Simmons D, Swinburn B, et al. Body size, body composition, and fat distribution: a comparison of young New Zealand men of European, Pacific Island, and Asian Indian ethnicities. N Z Med J. 2004 Dec 17;117(1207):U1203. https://www.ncbi.nlm.nih.gov/pubmed/15608799.
  15. Wiesenthal JD, Ghiculete D, D'A Honey RJ, Pace KT. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res. 2010 Aug;38(4):307-13. https://www.ncbi.nlm.nih.gov/pubmed/20625891. https://doi.org/10.1007/s00240-010-0295-0
  16. Kaya C, Kaynak Y, Karabag A, Aykaç A. The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes. Curr Med Imaging Rev. 2020;16(1):80-87. https://www.ncbi.nlm.nih.gov/pubmed/31989897. https://doi.org/10.2174/1573405614666180927112127