Optimization of shockwave lithotripsy use for single medium sized hard renal stone with stone density ≥ 1000 HU. A prospective study

• Published in: World journal of urology 2022, Vol.40 (1), p.243-250
• Main Authors: Elbaset, M. A., Taha, Diaa-Eldin, Anas, Marwan, Abouelkheir, Rasha T., Edwan, Mohamed, Abdullateef, Muhamad, Ashour, Rawdy, Osman, Yasser, Sheir, K. Z.
• Format: Article
• Language: English
• Subjects: Adult; Calculi; Female; Humans; Kidney Calculi - pathology; Kidney Calculi - therapy; Kidney stones; Kidneys; Lithiasis; Lithotripsy; Lithotripsy - standards; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Nephrolithiasis; Nephrology; Oncology; Original Article; Patients; Prospective Studies; Success; Treatment Outcome; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-021-03807-1

Purpose To identify shock wave lithotripsy (SWL) success predictors in hard renal stones (average stone density ≥ 1000 HU). Materials We prospectively evaluated patients who underwent SWL for hard renal stones between April 2018 and December 2020. Radiological parameters were identified, e.g., stone site, size, the average density in addition to stone core and shell mean density, and renal cortical thickness (RKT). SWL sessions were performed using Doli-S lithotripter till a maximum of 3–4 sessions with 2–4 weeks interval. Initial response to SWL included stone fragmentation and decreased stone size after the first SWL. Treatment success was considered if complete clearance of renal stones occurred or in case of clinically insignificant residual fragments ≤ 4 mm after 12 weeks follow up by NCCT. Results Out of 1878 patients who underwent SWL, the study included 157 patients with hard renal stones. Treatment overall success was found in 92 patients (58.6%) where 69 patients (43.9%) had complete stone clearance. On multivariate analysis, stone shell density