Ureteral wall volume at ureteral stone site is a critical predictor for shock wave lithotripsy outcomes: comparison with ureteral wall thickness and area

• Published in: Urolithiasis 2020-08, Vol.48 (4), p.361-368
• Main Authors: Yamashita, Shimpei, Kohjimoto, Yasuo, Iguchi, Takashi, Nishizawa, Satoshi, Kikkawa, Kazuro, Hara, Isao
• Format: Article
• Language: English
• Subjects: Aged; Endoscopy; Female; Forecasting; Humans; Lithotripsy; Male; Medical Biochemistry; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Organ Size; Original Paper; Patients; Retrospective Studies; Success; Treatment Outcome; Ureter - pathology; Ureteral Calculi - pathology; Ureteral Calculi - therapy; Urology
• ISSN: 2194-7228; 2194-7236
• DOI: 10.1007/s00240-019-01154-w

Our objectives were to compare measurements of ureteral wall area, ureteral wall volume and ureteral wall thickness for their use in prediction of shock wave lithotripsy outcomes. We retrospectively identified 218 patients that underwent shock wave lithotripsy for ureteral calculi with pretreatment non-contrast computed tomography. We measured ureteral wall thickness, ureteral wall area and ureteral wall volume by high functional viewer. Ureteral wall thickness was defined as the maximum thickness of ureteral wall, and ureteral wall area as the area of ureteral wall around the stone in the maximal stone diameter on axial computed tomography image. Ureteral wall volume was defined as the volume of ureteral wall from the upper to lower edge of the stone. Treatment success was defined as absence of residual fragments within 3 months after the first session. We compared the outcome predictive power among these parameters and logistic regression analysis to identify factors contributing to treatment failure. The treatment success rate was 47.6%. Ureteral wall thickness, ureteral wall area and ureteral wall volume in successful cases were all significantly smaller than those in unsuccessful cases (all p