Prognostic variables for shockwave lithotripsy (SWL) treatment success

• Verfasst von: Hatiboglu, Gencay [VerfasserIn]
• Verfasst von: Popeneciu, Valentin [VerfasserIn]
• Verfasst von: Kurosch, Martin Adalbert [VerfasserIn]
• Verfasst von: Huber, Johannes [VerfasserIn]
• Verfasst von: Pahernik, Sascha [VerfasserIn]
• Verfasst von: Pfitzenmaier, Jesco [VerfasserIn]
• Verfasst von: Haferkamp, Axel [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Titel: Prognostic variables for shockwave lithotripsy (SWL) treatment success
• Titelzusatz: no impact of body mass index (BMI) using a third generation lithotripter
• Verf.angabe: Gencay Hatiboglu, Valentin Popeneciu, Martin Kurosch, Johannes Huber, Sascha Pahernik, Jesco Pfitzenmaier, Axel Haferkamp and Markus Hohenfellner
• E-Jahr: 2011
• Jahr: 22 February 2011
• Umfang: 6 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 07.09.2022
• Titel Quelle: Enthalten in: BJU international
• Ort Quelle: Oxford : Wiley-Blackwell, 1999
• Jahr Quelle: 2011
• Band/Heft Quelle: 108(2011), 7, Seite 1192-1197
• ISSN Quelle: 1464-410X
• DOI: doi:10.1111/j.1464-410X.2010.10007.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: body mass index (BMI)
• Sach-SW: prognostic factor
• Sach-SW: shockwave lithotripsy (SWL)
• Sach-SW: urolithiasis
• K10plus-PPN: 1816000299

Abstract

Study Type - Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Therapy success in SWL treatment differs between individuals. According to recent studies done with first and second generation lithotripters, different prognostic variables like stone size, stone location, stone composition, age of patient and BMI have been shown to have prognostic relevance for outcome after SWL treatment. This study has been performed with a newer, third generation lithotripter. According to this study, BMI has no impact on SWL treatment success. Therefore, SWL treatment with newer generation lithotripters should be considered for the treatment of kidney stones in overweight and obese patients. OBJECTIVE • To investigate the effect of different variables including body mass index (BMI) on therapy outcome in patients with upper urinary tract stones treated with a third generation lithotripter, as BMI has been reported to be an independent predictor for stone-free status after extracorporeal shockwave lithotripsy (SWL) performed with first or second generation lithotripters. PATIENTS AND METHODS • In all, 172 patients with kidney stones with a mean (range) size of 9.2 (3.0-32.0) mm were included in the study. • In all, 91 patients (52.9%) were treated with a ureteric stent in situ. • For SWL therapy a third generation, electromagnetic lithotripter (Siemens LithoskopTM) was used. Stone-free status was reached, when no more treatable stones were present (no stone or stone < 3 mm). • BMI, stone size and localization, age, gender, treatment parameters and ureteric stent in situ were evaluated for their prognostic relevance on therapy success. RESULTS • The mean (range) BMI of all patients was 27.8 (19.0-58.6) kg/m2. • Patients were categorized into two groups: A) patients that were stone free after one treatment; B) patients with residual stones. The mean (sd) BMI was 27.4 (4.6) kg/m2 and 28.4 (6.1) kg/m2 for A and B, respectively. • Univariate and multivariate analysis for freedom of stones showed that only stone size (P < 0.01) and presence of a ureteric stent (P= 0.01) were independent prognostic variables. • BMI had no significant influence on therapy outcome (P= 0.51). CONCLUSIONS • Using a third generation lithotripter, BMI was not an independent predictor of stone-free rate after SWL therapy of kidney stones. • This effect might be attributed to a greater penetration depth of the shockwave energy. Stone size and a ureteric stent in situ were the only variables with prognostic significance.