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The factors that affecting shockwave lithotripsy treatment outcome of kidney stones

Bacground: We aimed to analyze combination of the schockwave lithotripy
(SWL) success predictors. Methods: In this retrospective study, the
outcomes of the patients with kidney stones treated with SWL were
analyzed. Adult patients (≥18 years) with complete records with
non-contrast computed tomography (NCCT), stone analysis, laboratory data
were involved in the study. Patients who were with urinary system
anomalies, who were receiving alpha-blocker and/or calcium channel
blockers and whom with impaired kidney function were excluded. The
effect of stone density, skin-to-stone distance (SSD), perirenal tissue
density (PTD), subcutaneous tissue density (STD), stone size, stone
burden, stone localization, infundibulopelvic angle (IA), as well as
body mass index (BMI) and stone analysis results on the success of the
treatment was evaluated. Results: SSD, PTD, STD, stone localization, IA,
as well as body-mass index, did not have any association with SWL
success. Stone size and stone burden had a significant association with
treatment success (p = 0.0001), and the cut-off values determined for
stone size and stone burden were 12.95 mm (p = 0.0006) and 121.38 mm2 (p
= 0.004) respectively. Stone density also had a significant association
with treatment success (p = 0.0001), and the cut-off value determined
for stone density was 739 HU (Hounsfield Unit) (p = 0.001). Treatment
success was significantly lower in cystine and calcium oxalate
monohydrate stones compared to other stone types (p = 0.019).
Conclusion: Significant markers that determine SWL effectiveness are
stone size, stone burden, stone density and, besides, stone type.