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Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study.
Scand J Urol Nephrol. 2003; 37(5):413-8.SJ

Abstract

OBJECTIVE

To define factors that have a significant impact on the stone-free rate after extracorporeal shock-wave lithotripsy (ESWL) of ureteric stones using multivariate analysis.

MATERIAL AND METHODS

Between February 1992 and February 2002, a total of 938 patients with ureteric stones were treated with in situ ESWL using the Dornier MFL 5000 lithotripter. The outcome of treatment was evaluated after 3 months and failure was defined as the presence of any residual stones. The stone-free rate was correlated with patient characteristics (age, sex and radiological renal picture) and stone features (site, side, length, width, nature, opacity and the presence of ureteral stents). Factors with a significant impact on the stone-free rate using the chi (2) test were further analyzed using multivariate analysis.

RESULTS

Overall, the stone-free rate was 88.7%. Repeat treatment was required in 50.4% of cases. Post-ESWL complications were observed in 32 cases (3.4%), including static steinstrasse in 19 (2%). Auxiliary procedures were needed in 28 cases (3%). Using the chi (2) test, only three factors had a significant impact on the stone-free rate, namely stone site, the transverse diameter of the stone and the presence of a ureteral stent. The stone-free rate was highest for stones located in the lumbar ureter (436/470; 92.8%) and lowest for those located in the pelvic ureter (268/324; 82.7%) (p = 0.0017). Stones with a transverse diameter of < or =1 cm were associated with a stone-free rate of 89.7% (715/797), compared to 83% (114/141) for those with a transverse diameter of >1 cm (p = 0.017). Non-stented patients had a stone-free rate of 89.8% (732/815), compared to 81.3% (100/123) for stented patients (p = 0.006). On multivariate analysis, these three factors maintained their statistical significance. A logistic regression model was designed to estimate the probability of stone-free status after ESWL.

CONCLUSION

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.

Authors+Show Affiliations

Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. unc@mum.mans.edu.egNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14594691

Citation

Abdel-Khalek, Mohamed, et al. "Prognostic Factors for Extracorporeal Shock-wave Lithotripsy of Ureteric Stones--a Multivariate Analysis Study." Scandinavian Journal of Urology and Nephrology, vol. 37, no. 5, 2003, pp. 413-8.
Abdel-Khalek M, Sheir K, Elsobky E, et al. Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study. Scand J Urol Nephrol. 2003;37(5):413-8.
Abdel-Khalek, M., Sheir, K., Elsobky, E., Showkey, S., & Kenawy, M. (2003). Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study. Scandinavian Journal of Urology and Nephrology, 37(5), 413-8.
Abdel-Khalek M, et al. Prognostic Factors for Extracorporeal Shock-wave Lithotripsy of Ureteric Stones--a Multivariate Analysis Study. Scand J Urol Nephrol. 2003;37(5):413-8. PubMed PMID: 14594691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones--a multivariate analysis study. AU - Abdel-Khalek,Mohamed, AU - Sheir,Khaled, AU - Elsobky,Emad, AU - Showkey,Saied, AU - Kenawy,Mahmoud, PY - 2003/11/5/pubmed PY - 2004/4/29/medline PY - 2003/11/5/entrez SP - 413 EP - 8 JF - Scandinavian journal of urology and nephrology JO - Scand J Urol Nephrol VL - 37 IS - 5 N2 - OBJECTIVE: To define factors that have a significant impact on the stone-free rate after extracorporeal shock-wave lithotripsy (ESWL) of ureteric stones using multivariate analysis. MATERIAL AND METHODS: Between February 1992 and February 2002, a total of 938 patients with ureteric stones were treated with in situ ESWL using the Dornier MFL 5000 lithotripter. The outcome of treatment was evaluated after 3 months and failure was defined as the presence of any residual stones. The stone-free rate was correlated with patient characteristics (age, sex and radiological renal picture) and stone features (site, side, length, width, nature, opacity and the presence of ureteral stents). Factors with a significant impact on the stone-free rate using the chi (2) test were further analyzed using multivariate analysis. RESULTS: Overall, the stone-free rate was 88.7%. Repeat treatment was required in 50.4% of cases. Post-ESWL complications were observed in 32 cases (3.4%), including static steinstrasse in 19 (2%). Auxiliary procedures were needed in 28 cases (3%). Using the chi (2) test, only three factors had a significant impact on the stone-free rate, namely stone site, the transverse diameter of the stone and the presence of a ureteral stent. The stone-free rate was highest for stones located in the lumbar ureter (436/470; 92.8%) and lowest for those located in the pelvic ureter (268/324; 82.7%) (p = 0.0017). Stones with a transverse diameter of < or =1 cm were associated with a stone-free rate of 89.7% (715/797), compared to 83% (114/141) for those with a transverse diameter of >1 cm (p = 0.017). Non-stented patients had a stone-free rate of 89.8% (732/815), compared to 81.3% (100/123) for stented patients (p = 0.006). On multivariate analysis, these three factors maintained their statistical significance. A logistic regression model was designed to estimate the probability of stone-free status after ESWL. CONCLUSION: 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. SN - 0036-5599 UR - https://www.unboundmedicine.com/medline/citation/14594691/Prognostic_factors_for_extracorporeal_shock_wave_lithotripsy_of_ureteric_stones__a_multivariate_analysis_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365590310006255 DB - PRIME DP - Unbound Medicine ER -