A Clinical Nomogram to Predict the Successful Shock Wave Lithotripsy of Renal and Ureteral Calculi

Abstract

No AccessJournal of UrologyAdult Urology1 Aug 2011A Clinical Nomogram to Predict the Successful Shock Wave Lithotripsy of Renal and Ureteral Calculi Joshua D. Wiesenthal, Daniela Ghiculete, A. Andrew Ray, R. John D.'A. Honey, and Kenneth T. Pace Joshua D. WiesenthalJoshua D. Wiesenthal , Daniela GhiculeteDaniela Ghiculete , A. Andrew RayA. Andrew Ray , R. John D.'A. HoneyR. John D.'A. Honey , and Kenneth T. PaceKenneth T. Pace View All Author Informationhttps://doi.org/10.1016/j.juro.2011.03.109AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although shock wave lithotripsy is dependent on patient and stone related factors, there are few reliable algorithms predictive of its success. In this study we develop a comprehensive nomogram to predict renal and ureteral stone shock wave lithotripsy outcomes. Materials and Methods: During a 5-year period data from patients treated at our lithotripsy unit were reviewed. Analysis was restricted to patients with a solitary renal or ureteral calculus 20 mm or less. Demographic, stone, patient, treatment and 3-month followup data were collected from a prospective database. All patients were treated using the Philips Lithotron® lithotripter. Results: A total of 422 patients (69.7% male) were analyzed. Mean stone size was 52.3 ± 39.3 mm2 for ureteral stones and 78.9 ± 77.3 mm2 for renal stones, with 95 (43.6%) of the renal stones located in the lower pole. The single treatment success rates for ureteral and renal stones were 60.3% and 70.2%, respectively. On univariate analysis predictors of shock wave lithotripsy success, regardless of stone location, were age (p = 0.01), body mass index (p = 0.01), stone size (p <0.01), mean stone density (p <0.01) and skin to stone distance (p <0.01). By multivariate logistic regression for renal calculi, age, stone area and skin to stone distance were significant predictors with an AUC of 0.75. For ureteral calculi predictive factors included body mass index and stone size (AUC 0.70). Conclusions: Patient and stone parameters have been identified to create a nomogram that predicts shock wave lithotripsy outcomes using the Lithotron lithotripter, which can facilitate optimal treatment based decisions and provide patients with more accurate single treatment success rates for shock wave lithotripsy tailored to patient specific situations. References 1 : 2007 Guideline for the management of ureteral calculi. Eur Urol2007; 52: 1610. Google Scholar 2 : Management of kidney stones. BMJ2007; 334: 468. Google Scholar 3 : Two-year experience with ureteral stones: extracorporeal shockwave lithotripsy v ureteroscopic manipulation. J Endourol1998; 12: 501. 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Link, Google Scholar Division of Urology, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMannil M, von Spiczak J, Hermanns T, Poyet C, Alkadhi H and Fankhauser C (2018) Three-Dimensional Texture Analysis with Machine Learning Provides Incremental Predictive Information for Successful Shock Wave Lithotripsy in Patients with Kidney StonesJournal of Urology, VOL. 200, NO. 4, (829-836), Online publication date: 1-Oct-2018.Choo M, Uhmn S, Kim J, Han J, Kim D, Kim J and Lee S (2018) A Prediction Model Using Machine Learning Algorithm for Assessing Stone-Free Status after Single Session Shock Wave Lithotripsy to Treat Ureteral StonesJournal of Urology, VOL. 200, NO. 6, (1371-1377), Online publication date: 1-Dec-2018.Griebling T (2018) Re: Age-Related Delay in Urinary Stone Clearance in Elderly Patients with Solitary Proximal Ureteral Calculi Treated by Extracorporeal Shock Wave LithotripsyJournal of Urology, VOL. 195, NO. 5, (1493-1494), Online publication date: 1-May-2016.Assimos D (2018) Re: S.T.O.N.E. Nephrolithometry: Novel Surgical Classification System for Kidney CalculiJournal of Urology, VOL. 190, NO. 6, (2124-2125), Online publication date: 1-Dec-2013.Assimos D (2018) Re: Predictive Factors of the Outcome of Extracorporeal Shockwave Lithotripsy for Ureteral StonesJournal of Urology, VOL. 188, NO. 6, (2257-2257), Online publication date: 1-Dec-2012. Volume 186Issue 2August 2011Page: 556-562 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordstreatment outcomeurolithiasisnomogramslithotripsyMetricsAuthor Information Joshua D. Wiesenthal Nothing to disclose. More articles by this author Daniela Ghiculete Nothing to disclose. More articles by this author A. Andrew Ray Nothing to disclose. More articles by this author R. John D.'A. Honey Financial interest and/or other relationship with Cook, Boston Scientific and Pleuromed. More articles by this author Kenneth T. Pace Financial interest and/or other relationship with Sanofi-Synthelabo, Cook Urological Inc., Baxter Inc. and Pharmascience Inc. More articles by this author Expand All Advertisement PDF downloadLoading ...