Treatment outcomes and factors affecting the success of extracorporeal shockwave lithotripsy in urinary stone treatment: a study of ten years of data from Mahasarakham Hospital

Abstract

Objective: To explore the outcome and factors affecting the success of Extracorporeal Shockwave Lithotripsy in upper urinary stone treatment. Materials and Methods: A retrospective review of 4,293 patients with renal or ureteric stones were treated with ESWL using Siemens Modularis Vario lithotripter at Mahasarakham Hospital between October 2011 and September 2020. NCCT or IVU were used to determine stone characteristics. All patients were followed up at week 12 after treatment to evaluate treatment outcome. The success was defined in cases of the presence of clinically insignificant residual ≤ 4 mm or complete clearance of the stones. Data were tested with multivariate logistic regression analysis to determine the predictors of ESWL success. Results: The overall success rate was 70.1 %. The success rate of patients in the age ≤ 40 years was 78.2% The lowest success rate was from lower calyceal stone with 54.6%, the success rate was 76.3% for stone ≤ 10 mm. and the success rate of stone in surface area ≤ 50 mm2 was 77.0%. The complication rate was 5.2%, and auxiliary procedures were 4%. The mean number of ESWL sessions was 2.1. Multivariable logistic regression analysis demonstrated that age, stone size, stone surface area and stone location were significant predictors of ESWL success. Conclusion: Renal and ureteric stones treatment with ESWL showed good results. Failure of ESWL was observed more in cases of patients with the age of > 40 years, stone size of > 10 mm, stone surface area of > 50 mm2 and location at lower calyx.