Factors that Affecting Success and Re-admission in the Treatment of Proximal Ureteral Stones with Shock Wave Lithotripsy

OpenAlex İngilizce

Introduction: Extracorporeal shock wave lithotripsy (ESWL) is one of the methods applied in urinary system stone disease.ESWL has a very high success rate, and there are many factors that affect its success.In our study, we aimed to present our shock wave lithotripsy (SWL) results in proximal ureter stones, the reasons for re-admission to the hospital after SWL, and the final success achieved after additional interventions.Methods: Between March 2017 and October 2019, 142 patients aged 18 years and over who underwent SWL for proximal ureteral stones were retrospectively evaluated.Age, sex, body mass index, stone laterality, stone size and volume (π×1/ 6×length×width×height), stone-skin distance, stone density, hydronephrosis degrees, number of SWL sessions, reasons for re-admission, and final success results were evaluated.The stone size determined on CT<4 mm was defined as successful SWL treatment.Other interventional procedures were performed to unsuccessful SWL patients, and final success rate was determined.Complications were classified according to Clavien-Dindo classification.Results: Age, BMI, laterality of the stone, degree of renal ectasia, number of SWL sessions, and stone-skin distance did not contribute to SWL success (p>0.05).Factors affecting ESWL success include male gender, stone size, stone volume, and stone density; stone-skin distance and degree of renal ectasia were found to affect final success (p<0.05).Complications were more frequent in the unsuccessful group (p<0.05).Discussion and Conclusion: Stone volume, size and density of stone in proximal ureter stones are among the factors affecting the SWL success.The final success rate can be increased after additional interventions performed in the necessary situations of SWL, which is a minimally invasive procedure.