Impact of Pretreatment Hydronephrosis on the Success Rate of Shock Wave Lithotripsy in Patients with Ureteral Stone
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Purpose: To evaluate predictors of the success rate for one session of shock wave lithotripsy (SWL), focusing on the relationships between pretreatment hydronephrosis grade and one-session SWL success rates. Materials and Methods: The medical records of 1824 consecutive patients who underwent an initial session of SWL for treatment of urinary stones between 2005 and 2013 were reviewed. After exclusion, 700 patients with a single, 4–20 mm diameter radiopaquecalculus were included in the study. Results: The mean maximal stone length (MSL) and skin-to-stone distance were 9.2±3.9 and 110.8±18.9 mm, respectively. The average values for mean stone density (MSD) and stone heterogeneity index (SHI) were 707.0±272.1 and 244.9±110.1, respectively. One-session success rates were 68.4, 75.0, 75.1, 54.0, and 10.5% in patients with hydronephrosis grade 0, 1, 2, 3, and 4, respectively. Patients were classified into success or failure groups based on SWL outcome. Multivariate logistic regression analyses revealed that MSL [odds ratio (OR) 0.888, 95% confidence intervals (CI): 0.841–0.934, p<0.001], MSD (OR 0.996, 95% CI: 0.995–0.997, p< 0.001), SHI (OR 1.007, 95% CI: 1.005–1.010, p<0.001), and pretreatment hydronephrosis grade (OR 0.601, 95% CI: 0.368–0.988, p= 0.043) were significantly associated with one-session success. Conclusion: Pretreatment grades 3 or 4 hydronephrosis were associated with failure of SWL in patients with a single ureteral stone. In the presence of severe hydronephrosis, especially hydronephrosis grade 4; physicians should proceed cautiously in choosingand offering SWL as the primary treatment for ureteral stone.
Abstract
Purpose: To evaluate predictors of the success rate for one session of shock wave lithotripsy (SWL), focusing on the relationships between pretreatment hydronephrosis grade and one-session SWL success rates. Materials and Methods: The medical records of 1824 consecutive patients who underwent an initial session of SWL for treatment of urinary stones between 2005 and 2013 were reviewed. After exclusion, 700 patients with a single, 4–20 mm diameter radiopaquecalculus were included in the study. Results: The mean maximal stone length (MSL) and skin-to-stone distance were 9.2±3.9 and 110.8±18.9 mm, respectively. The average values for mean stone density (MSD) and stone heterogeneity index (SHI) were 707.0±272.1 and 244.9±110.1, respectively. One-session success rates were 68.4, 75.0, 75.1, 54.0, and 10.5% in patients with hydronephrosis grade 0, 1, 2, 3, and 4, respectively. Patients were classified into success or failure groups based on SWL outcome. Multivariate logistic regression analyses revealed that MSL [odds ratio (OR) 0.888, 95% confidence intervals (CI): 0.841–0.934, p<0.001], MSD (OR 0.996, 95% CI: 0.995–0.997, p< 0.001), SHI (OR 1.007, 95% CI: 1.005–1.010, p<0.001), and pretreatment hydronephrosis grade (OR 0.601, 95% CI: 0.368–0.988, p= 0.043) were significantly associated with one-session success. Conclusion: Pretreatment grades 3 or 4 hydronephrosis were associated with failure of SWL in patients with a single ureteral stone. In the presence of severe hydronephrosis, especially hydronephrosis grade 4; physicians should proceed cautiously in choosingand offering SWL as the primary treatment for ureteral stone.
참고문헌 (25)
- Frabboni R, "In situ echoguided extracorporeal shock wave lithotripsy of ureteric stones with the Dornier MPL 9000: a multicentric study group", Br J Urol, 73, pp.487~493 (1994)
- Creagh TA, "In situ ESWL for ureteric calculi: the optimum treatment?", Ir J Med Sci, 162, pp.348~350 (1993)
- Singal RK, "Contemporary management of ureteral stones", Urol Clin North Am, 24, pp.59~70 (1997)
- Srivastava A, "Management of impacted upper ureteric calculi: results of lithotripsy and percutaneous litholapaxy", Br J Urol, 70, pp.252~257 (1992)
- Delakas D, "Independent predictors of failure of shockwave lithotripsy for ureteral stones employing a second-generation lithotripter", J Endourol, 17, pp.201~205 (2003)
- Wang M, "Prediction of outcome of extracorporeal shock wave lithotripsy in the management of ureteric calculi", Urol Res, 39, pp.51~57 (2011)
- El-Assmy A, "Impact of the degree of hydronephrosis on the efficacy of in situ extracorporeal shock-wave lithotripsy for proximal ureteral calculi", Scand J Urol Nephrol, 41, pp.208~213 (2007)
- Kageyama S, "An investigation of factors associated with failure of extracorporeal shock wave lithotripsy for ureteral calculi", Hinyokika Kiyo, 46, pp.371~376 (2000)
- Cho KS, "Optimal skin-to-stone distance is a positive predictor for successful outcomes in upper ureter calculi following extracorporeal shock wave lithotripsy: a Bayesian model averaging approach", PLoS One, 10, pp.e0144912~ (2015)
- Chung DY, "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, 10, pp.e0123800~ (2015)
- Lee JY, "Stone heterogeneity index as the standard deviation of Hounsfield units: a novel predictor for shock-wave lithotripsy outcomes in ureter calculi", Sci Rep, 6, pp.23988~ (2016)
- Seitz C, "Extracorporeal shock wave lithotripsy in the treatment of proximal ureteral stones: does the presence and degree of hydronephrosis affect success?", Eur Urol, 49, pp.378~383 (2006)
- Fernbach SK, "Ultrasound grading of hydronephrosis:introduction to the system used by the Society for Fetal Urology", Pediatr Radiol, 23, pp.478~480 (1993)
- Skolarikos A, "Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention", Eur Urol, 50, pp.981~990 (2006)
- Augustin H, "Prediction of stone-free rate after ESWL", Eur Urol, 52, pp.318~320 (2007)
- Kim HH, "In situ extracorporeal shockwave lithotripsy for ureteral calculi: investigation of factors influencing stone fragmentation and appropriate number of sessions for changing treatment modality", J Endourol, 10, pp.501~505 (1996)
- Gupta NP, "Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi", BJU Int, 95, pp.1285~1288 (2005)
- 임기홍, "Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones?", Investigative and Clinical Urology, 56(1), pp.56~62 (2015), 대한비뇨기과학회
- Hofbauer J, "ESWL in situ or ureteroscopy for ureteric stones?", World J Urol, 11, pp.54~58 (1993)
- Kanao K, "Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy", J Urol, 176(4 Pt 1), pp.1453~1456 (2006)
- Abe T, "Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution", J Endourol, 19, pp.768~773 (2005)
- Mugiya S, "Endoscopic features of impacted ureteral stones", J Urol, 171, pp.89~91 (2004)
- Morgentaler A, "Management of the impacted ureteral calculus", J Urol, 143, pp.263~266 (1990)
- Mugiya S, "Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor", J Urol, 164, pp.329~331 (2000)
- Türk C, "EAU guidelines on interventional treatment for urolithiasis", Eur Urol, 69, pp.475~482 (2016)