OJU  Vol.4 No.3 , March 2014
Success Factors of Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal & Ureteric Calculi in Adult
Abstract: The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL. Methods: A total of 417 patients harboring renal or ureteral stones underwent extracorporeal shock wave lithotripsy (ESWL) between October 2008 and July 2012. Eighty five patients were lost on follow up. The remaining (n = 332). All patients were >18 yr of age. Siemens and SLX-F2 electromagnetic machines were used to impart shock waves. Patients were stratified according to localization (pelvic, calyceal, or ureteral stones) and stone size (up to 10 mm, 10 - 20 mm, and >20 mm). Result: The overall success rate was 251/332 (75.6%) achieve stone free status. Repeated ESWL sessions were needed in 258 (61.9%). Of eleven variables were studied including age, sex, side, location (pelvic, calyx, ureter), ureteric stent, previous renal surgery, stone size, number of shock waves, opacity of stone, renal system state, and type of lithotripter, three variables were significantly affect the success rate namely stone size, number of shock waves and location of stone. Conclusions: ESWL remains one of the most commonly utilized treatments for patients with upper urinary tract calculi; Stone diameter, location, and number of shock waves, are the most important predictors determining stone clearance after ESWL of renal and ureteric calculi. To optimize treatment outcomes with ESWL the presence of treating urologist is essential to optimize the final result.
Cite this paper: Abid, A. (2014) Success Factors of Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal & Ureteric Calculi in Adult. Open Journal of Urology, 4, 26-32. doi: 10.4236/oju.2014.43005.

[1]   Matlaga, B.R. and Semins, M.J. (2009) How to Improve Results with Extracorporeal Shock Wave Lithotripsy. Therapeutic Advances in Urology, 1, 99-105.

[2]   Wiesenthal, J.D., Ghiculete, D., D’A Honey, R.J. and Pace, K.T. (2010) Evaluating the Importance of Mean Stone Density and Skin-to-Stone Distance in Predicting Successful Shock Wave Lithotripsy of Renal and Ureteric Calculi. Urological Research, 38, 307-313.

[3]   Tiselius, H.-G. (2008) The Low-Invasiveness of ESWL Combined with Its High Success Rate. When the EAU and AUA Expert Panel Had Reviewed the Recent Literature on the management of Patients with Stone.

[4]   Elkoushy, M.A., Hassan, J.A., Morehouse, D.D., Anidjar, M. and Andonian, S. (2011) Factors Determining Stone-Free Rate in Shock Wave Lithotripsy Using Standard Focus of Storz Modulith SLX-F2 Lithotripter. Urology, 78, 759-763.

[5]   Steinberg, P.L., Williams, S. and Hoenig, D.M. (2010) Adjuncts to Improve Outcomes of Shock Wave Lithotripsy Current Urology Reports. 11, 93-97.

[6]   El-Assmy, A., El-Nahas, A.R. and Mohamed, E. (2006) Predictors of Success after Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Calculi between 20 -30 mm: A Multivariate Analysis Model. The Scientific World Journal, 6, 2388-2390

[7]   Gallagher, H.J. and Tolley, D.A. (2000) AD: Still a Role for the Intravenous Urogram in Stone Management? Current Opinion in Urology, 10, 551-555. 11000-00003

[8]   Furia, J.P. (2005) Safety and Efficacy of Extracorporeal Shock Wave Therapy for Chronic Lateral Epicondylitis. The American Journal of Orthopedics, 34, 13-19.

[9]   Yilmaz, E., Batislam, E., Basar, M., Tuglu, E., Mert, C. and Basar, H. (2005) Optimal Frequency in Extracorporeal Shock Wave Lithotripsy: Prospective Randomized Study. Urology, 66, 1160-1164.

[10]   Albala, D.M., Assimos, D.G., Clayman, R.V., Denstedt, J.D., Grasso, M., Gutierrez-Aceves, J., et al. (2001) Lower Pole I: A Prospective Randomized Trial of Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrostolithotomy for Lower Pole Nephrolithiasis—Initial Results. Journal of Urology, 166, 2072-2080.

[11]   Renner, C. and Rassweiler, J. (1999) Treatment of Renal Stones by Extracorporeal Shock Wave Lithotripsy. Nephron, 81, 71-81.

[12]   Portis, A.J., Yan, Y., Pattaras, J.G., Andreoni, C., Moore, R. and Clayman, R.V. (2003) Matched Pair Analysis of Shock Wave Lithotripsy Effectiveness for Comparison of Lithotripters. Journal of Urology, 169, 58-62.

[13]   Verze, P., Imbimbo, C., Cancelmo, G., Creta, M., Palmieri, A., Mangiapia, F., Buonopane, R. and Mirone, V. (2010) Extracorporeal Shockwave Lithotripsy vs. Ureteroscopy as First-Line Therapy for Patients with Single, Distal Ureteric Stones: A Prospective Randomized Study. BJU International, 106, 1748-1752.

[14]   Galvin, D.J. and Pearle, M.S. (2006) The Contemporary Management of Renal and Ureteric Calculi. BJU International, 98, 1283-1288.

[15]   Wiesenthal, J.D., Ghiculete, D., Ray, A.A., Honey, R.J. and Pace, K.T.A. (2011) Clinical Nomogram to Predict the Successful Shock Wave Lithotripsy of Renal and Ureteral Calculi. Journal of Urology, 186, 556-562.

[16]   Lucio 2nd, J., Korkes, F., Lopes-Neto, A.C., et al. (2011) Steinstrasse Predictive Factors and Outcomes after Extracorporeal Shockwave Lithotripsy. Int Braz J Urol., 37, 477-482.

[17]   Argyropoulos, A.N. and Tolley, D.A. (2009) Ureteric Stents Compromise Stone Clearance after Shockwave Lithotripsy for Ureteric Stones: Results of a Matched-Pair Analysis. BJU International, 103, 76-80.

[18]   Musa, A.A.K. (2008) Use of Double-J Stents Prior to Extracorporeal Shock Wavelithotripsy Is Not Beneficial: Results of a Prospective Randomized Study. International Urology and Nephrology, 40, 19-22.

[19]   El-Assmy, A., El-Nahas, A.R. and Sheir, K.Z. (2006) Is Pre-Shock Wave Lithotripsy Stenting Necessary for Ureteral Stones with Moderate or Severe Hydronephrosis? Journal of Urology, 176, 2059-2062.