Abstract
Objectives To define the factors that affect the success rate of extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureteric stones. Patients and methods Between January 2000 and December 2003, 468 patients with ureteric stones underwent in situ ESWL using Storz SL 20 lithotriptor. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones. Characteristics of the patients, condition of the urinary tract and stone features were correlated to the success rate to define the significant predictors of success. Results At 3-month follow-up, the overall success rate was 394/468 (84.2%). Repeat treatment was required in 239 patients (51.1%). Post-ESWL auxiliary procedures were necessary in 58 patients (12.4%). Post-ESWL complications were observed in 11 patients (2.4%). Only three factors had a significant impact on the stone-free rate, namely stone site, stone width and the presence of a ureteral stent. The stone-free rate was highest for stones located in the lumbar ureter (159/183; 86.9%) and lowest for those in iliac ureter (28/40; 70%) (P < 0.05). Stones with a transverse diameter <8 mm were associated with a stone-free rate of 89.9% (248/276), compared to 66.7% (128/192) for those with a transverse diameter of >8 mm (P < 0.01). Non-stented patients had a stone-free rate of 89.2% (313/348), compared to 75.2% (85/113) for stented patients (P < 0.01). Conclusions The site and transverse diameter of the stone and the presence of a ureteral stent are the only significant predictors of success of ESWL therapy for ureteric stones.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Abdel-Khalek M, Sheir KZ, Elsobky E, Showkey S, Kenawy M (2003) Prognostic factors for extracorporeal shockwave lithotripsy of ureteric stones: A multivariate analysis study. Scand J Urol Nephrol 37:413–418
Azm TA, Higazy H (2002) Effect of diuresis on extracorporeal shockwave lithotripsy treatment of ureteric stones. Scand J Urol Nephrol 36:209–212
Gnanpragasam VJ, Ramsden PD, Murtly LS, Thomas DJ (1999) Primary in situ extracorporeal shock wave lithotripsy in management of ureteric calculi: results with a third generation lithotriptor. BJU Int 84:770–774
Ilker NY, Alican Y, Simsek F, Turkeri LN, Ahdas A (1994) Ureteral extracorporeal shock wave lithotripsy utilizing the Dornier MFL 5000. J Endourol 8:13–14
Mogensen P, Andrsen JT (1994) Primary in situ extracorporeal shock wave lithotripsy for ureteral calculi. Scand J Urol Nephrol 157(Suppl):159–163
Hofbauer J, Tuerk C, Hobarth K, Hasum R, Marberger M (1993) ESWL in situ or ureteroscopy for ureteric stones. World J Urol 11:54–58
Ehtet JT, Drach GW, Arnett ML, Barrett RB, Govan D, Lingeman J et al (1994) Extracorporeal shock wave lithotripsy: multicenter study of kidney and upper ureter versus middle and lower ureter. J Urol 152:1379–1385
Rauchenwald M, Colombo T, Petritsch Vilits P, Humber G (1992) In situ extracorporeal shock wave lithotripsy of ureteral calculi with the MPL 9000 lithotriptor. J Urol 148:1097–1101
Fetner CD, Preminger GH, Seger J, Lea TA (1988) Treatment of ureteric calculi by extracorporeal shock wave lithotripsy at multi-user center. J Urol 139:1192–1195
Segura JW, Preminger GM, Assimos DG, Dretiler SP, Kahn RI, Lingeman JE et al (1997) Ureteral Stones Clinical Guidelines Panel Summary report on the management of ureteral calculi. The American Urological Association. J Urol 158:1915–1921
Whitfield HN (1999) The management of ureteric stones. Part II: Therapy. BJU Int 84:916–921
Ryan PC, Lemon GM, Melean PA, Fitzpatrick JM (1994) The effects of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit. Br J Urol 74:434–439
Buchholz NP, Van Rossum M (2001) Shock wave lithotripsy treatment of radiolucent ureteric calculi with the help of contrast medium. Eur Urol 39:200–203
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Salman, M., Al-Ansari, A.A., Talib, R.A. et al. Prediction of success of extracorporeal shock wave lithotripsy in the treatment of ureteric stones. Int Urol Nephrol 39, 85–89 (2007). https://doi.org/10.1007/s11255-006-0104-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-006-0104-4