Examination of predictive factors for therapeutic effect of SWL on ureteral stone

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  • 尿管結石に対するSWL治療効果予測因子の検討
  • ニョウカン ケッセキ ニ タイスル SWL チリョウ コウカ ヨソク インシ ノ ケントウ

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Abstract

<p>  We retrospectively compared a group treated by only extracorporeal shock wave lithotripsy (SWL) with a group additionally treated by transurethral lithotripsy (TUL) for urinary tract stones. Between January 2012 and December 2017, ninety-four patients were initially treated by SWL and stone-free. “Stone-free” was defined as the situation that stones were completely removed or the residual fragments were ≦4mm. The age, sex, body mass index (BMI), stone location, Hounsfield units (HU), stone size, stone-surface area (SSA), existence of hydronephrosis before the operation, and skin-to-stone distance (SSD) were evaluated to determine the predictive factors for successful treatment by only SWL.</p><p>  Thirty-two patients (34.0%), who were initially treated by SWL, needed to additional treatment with TUL. Univariate analysis of ninety-four patients showed that U1 stones [U2-3 vs. U1 ; OR, 3.33 ; 95%CI, 1.37-8.35 ; p = 0.0075], SSD ≦ 100 mm [SSD ≧ 100 mm vs. SSD<100mm ; OR, 7.96 ; 95%CI, 2.49-35.70 ; p=0.0002] were predictive factors for successful treatment by only SWL. Multivariate analysis of the ninety-four patients showed that “U1 stone”[U2-3 vs. U1 ; OR, 3.69 ; 95%CI, 1.42-10.13 ; p=0.0070] and “SSD ≦100mm”[SSD≧100mm vs. SSD<100mm ; OR, 8.40 ; 95%CI, 2.51-39.20 ; p=0.0002] were predictive factors for successful treatment by SWL. “U1 stones” and “SSD≦100mm” are effective to predict treatment success using only SWL based on the results of this study.</p>

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