Document Detail

Independent predictors of failure of shockwave lithotripsy for ureteral stones employing a second-generation lithotripter.
MedLine Citation:
PMID:  12816580     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To define factors associated with the failure of shockwave lithotripsy (SWL) in the treatment of ureteral stones. PATIENTS AND METHODS: We retrospectively studied 405 men and 283 women (mean age 52.6 years) who underwent SWL with a second-generation lithotripter in the period 1994 to 2001. We evaluated available clinical and radiologic features that might have been related to failure of SWL therapy. RESULTS: Treatment was successful in 502 patients (73%). The 186 patients (27%) in whom treatment failed underwent endourologic alternatives or open surgery. Multivariate logistic regression analysis revealed that unsuccessful outcome was significantly related to: (1) pelvic ureteral stones (odds ratio [OR] 4.02; 95% CI 1.97, 8.19); (2) stone size >10 mm (OR 3.46; 95% CI 2.16, 5.53); (3) obstruction (OR 1.93; 95% CI 0.99, 3.77); and (4) obesity (OR 1.87; 95% CI 0.95, 3.77). Although the predictive value of each individual parameter was relatively low (15.3%-27.9%) the cumulative risk was 82.95% when patients had all four features. The strongest independent predictors of failure were pelvic stones and stones >10 mm (cumulative predictive value 57.3%). CONCLUSIONS: These variables may enable identification of a subgroup of patients who will fail initial SWL. These patients may be candidates for endourologic alternatives as first-line treatment.
Dimitrios Delakas; Ioannis Karyotis; George Daskalopoulos; Emmanuel Lianos; Emmanuel Mavromanolakis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  17     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-06-20     Completed Date:  2003-07-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  201-5     Citation Subset:  IM    
Department of Urology, General University Hospital, Heraklion, Crete, Greece.
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MeSH Terms
Aged, 80 and over
Body Mass Index
Kidney Pelvis / pathology*
Logistic Models
Middle Aged
Multivariate Analysis
Obesity / complications
Retrospective Studies
Risk Factors
Stents / adverse effects
Treatment Failure
Ureteral Calculi / pathology*,  therapy*
Ureteral Obstruction / complications*

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