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Fate of residual fragments after successful extracorporeal shock wave lithotripsy
M Shigeta1, Y Kasaoka, H Yasumoto
1Department of Urology, Hiroshima University School of Medicine, Japan. mshigeta@mcai.med.hiroshima-u.ac.jp
Purpose:
The aim of the present study was to investigate the reason residual fragments from upper urinary tract calculi failed to clear after successful extracorporeal shock wave lithotripsy (ESWL).
Methods:
Risk factors were analyzed in 161 patients with residual fragments (< or = 4 mm) that had remained for more than 3 months after ESWL. The factors examined in the present study were gender, a history of urolithiasis, the number, location and size of stones, hydronephrosis 3 months after ESWL and bacteriuria before ESWL. The mean follow-up period was 20.0 months (range 6-69 months).
Results:
The overall stone-free rate was 14.3%. The stone-free rate in patients with multiple stones or hydronephrosis 3 months after ESWL was significantly lower than that in patients without these conditions (P < 0.05 and P < 0.01, respectively). The cumulative non-clearance rate in patients with hydronephrosis was significantly higher than in patients without this condition (P < 0.05). Results of Cox's proportional hazards model indicated that hydronephrosis was the most important and only significant factor for failure to clear of the seven factors investigated (P < 0.05).
Conclusion:
Hydronephrosis was most highly correlated with the fate of residual fragments after ESWL.