Factors affecting extracorporeal shock wave lithotripsy (ESWL) success
Keywords:Extracorporeal Shock Wave Lithotripsy (ESWL), Kidney stone, Lithotripsy
Objective: Our aim in this study was to evaluate the predictive properties of success in patients who underwent Extracorporeal shock wave lithotripsy (ESWL).
Materials and methods: The medical records of 176 patients, who underwent ESWL for kidney stones were retrospectively reviewed. The study focused on individuals with single kidney stones measuring less than 2 cm. After the ESWL, patients who were not stone-free were evaluated as group 1, and stone free patients as group 2.
Results: The study encompassed two distinct groups: Group 1 with 67 participants and Group 2 consisting of 109 participants. In this study, which included 176 patients, the incidence of stone-free was found to be 62% (109/176). Of the patients, 56% (n=99) underwent ESWL once, 31% (n=55) twice, 8% (n=14) three times, 3% (n=5) four times, and 2% (n=3) received the treatment five times. Group 1 stones exhibited an average density of 978±357 HU, contrasting with Group 2's 784±318 HU. The disparity between these groups was significant, with a p-value of <0.001. Group 1 stones averaged 11.7±4.2 mm in size, while those in Group 2 measured 9.4±3.9 mm on average (p<0.001). According to the logistic regression test results, it was determined that stone size (p=0.007, OR: 0.89) and stone density (p=0.002, OR: 0.99) were two important independent predictors affecting the success of ESWL. Using a cut-off value of 1025 HU for stone density, we observed a sensitivity of 50% and a specificity of 82% in predicting the success of ESWL. The area under the curve (AUC) was 0.67.
Conclusions: ESWL remains a valuable, non-invasive modality for the management of kidney stones. Stone size and density stand out as key predictive parameters for its success.
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