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. 2018 Apr-Jun;10(2):159-164.
doi: 10.4103/UA.UA_84_17.

Role of clinical and radiological parameters in predicting the outcome of shockwave lithotripsy for ureteric stones

Hemant Goel  1 , Sumit Gahlawat  1 , Malay Kumar Bera  2 , Dilip Kumar Pal  2 , Onam Aggarwal  3
Affiliations

Role of clinical and radiological parameters in predicting the outcome of shockwave lithotripsy for ureteric stones

Hemant Goel et al. Urol Ann. 2018 Apr-Jun.

Abstract

Introduction: Shockwave-lithotripsy (SWL) provides a noninvasive and effective option for the management of ureteric calculi. Several factors may affect the success of SWL. Identification of these predictive factors will both increase the efficacy and decrease the cost. This study was designed to identify factors affecting the outcome of SWL for ureteral stones.

Materials and methods: This study was conducted from March 2012 to November 2014 in patients with solitary ureteric calculi who were managed with SWL. Data were analyzed to identify clinical and radiological factors associated with treatment outcome. Success after SWL was described as complete stone clearance or clinically insignificant residual fragments <3 mm at 3 months after SWL.

Results: A total of 110 patients with ureteric calculi were divided into two groups depending on the outcome of SWL, Group A (successful - 76%) and Group B (failed - 24%). Stone size, Skin to stone distance (SSD), secondary signs of obstruction, and presence of double J (DJ) Stent, all were significantly associated with the outcome of SWL on univariate analysis. On multivariate analysis, stone size, hounsfield unit, SSD, and DJ stent were the independent factors affecting the outcome of SWL. On Receptor-Operator Characteristic curve analysis, a cutoff value of 8.2 mm for the stone size was found which best predicts a successful outcome, with a sensitivity of 54% and specificity of 96%.

Conclusion: The findings of this study suggest that Stone size, SSD, the presence of DJ stent, and stone attenuation values are the significant factors that influence the outcome of SWL in patients with ureteral stones.

Keywords: Outcome; shockwave-lithotripsy; ureteric stones; ureterolithiasis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic curve analysis to determine stone size cut off that best predicts a successful outcome of shockwave lithotripsy for ureteral stones
See this image and copyright information in PMC

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