Extracorporeal piezoelectric shock wave lithotripsy as mono and multiple therapy of large renal calculi including staghorn stones in unanaesthetized patients under semi‐ambulant conditions

Bruns, T.; Stein, John P.; Tauber, R.

doi:10.1111/j.1464-410x.1995.tb07260.x

Cited by 10 publications

(3 citation statements)

References 19 publications

(4 reference statements)

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“…Many investigators believe that pre-ESWL JJ stenting of large renal stones helps to prevent obstruction and facilitates passage of fragments [8,21]. On the other hand Ryan et al [22] showed that in situ ureteric stents impair ureteric peristalsis and/or trap large fragments, thus delaying stone clearance.…”

Section: Discussionmentioning

confidence: 99%

“…In all studies that investigated the factors affecting ESWL outcome in management of large renal stones [7,8,9,10], a univariate analysis was only utilized, which does not take into account the possible interactions between the examined variables. To overcome this serious limitation, one has to resort to multivariate statistical techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies reported the prognostic factors of ESWL in large renal calculi [7,8,9]. However, predictors of success of ESWL in patients with renal calculi of 20-30 mm that would differentiate between those who should be treated by ESWL and those who should undergo other treatment modalities are yet to be definitively determined.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Success After Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Calculi Between 20-30mm: A Multivariate Analysis Model

El‐Assmy¹,

El-Nahas²,

Abo-Elghar³

et al. 2006

European Urology Supplements

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The first-line management of renal stones between 20-30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups.Between January 1990 and January 2004, 594 patients with renal stones 20-30 mm in length underwent ESWL monotherapy. Stone surface area was measured for all stones. The results of treatment were evaluated after 3 months of follow-up. The stone-free rate was correlated with stone and patient characteristics using the Chi-square test; factors found to be significant were further analyzed using multivariate analysis.Repeat ESWL was needed in 56.9% of cases. Post-ESWL complications occurred in 5% of cases and post-ESWL secondary procedures were required in 5.9%. At 3-month follow-up, the overall stone-free rate was 77.2%. Using the Chi-square test, stone surface area, location, number, radiological renal picture, and congenital renal anomalies had a significant impact on the stone-free rate. Multivariate analysis excluded radiological renal picture from the logistic regression model while other factors maintained their statistically significant effect on success rate, indicating that they were independent predictors. A regression analysis model was designed to estimate the probability of stone-free status after ESWL. The sensitivity of the model was 97.4%, the specificity 90%, and the overall accuracy 95.6%.Stone surface area, location, number, and congenital renal anomalies are prognostic predictors determining stone clearance after ESWL of renal calculi of 20-30 mm. High probability of stone clearance is obtained with single stone ≤400 mm 2 located in renal pelvis with no congenital anomalies. Our regression model can predict the probability of the success of ESWL in such controversial groups and can define patients who would need other treatment modality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of Success After Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Calculi Between 20-30mm: A Multivariate Analysis Model

El‐Assmy¹,

El-Nahas²,

Abo-Elghar³

et al. 2006

European Urology Supplements

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Review of the Clinical Guidelines for Staghorn Calculi

Nutahara

Higashihara

Yamaguchi³

et al. 2003

Clinical Guidelines in Urological Management

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Neutrophil gelatinase-associated lipocalin (NGAL) value changes before and after shock wave lithotripsy

et al. 2016

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Our aim was to determine short and medium-term changes of neutrophil gelatinase-associated lipocalin (NGAL) in the urine of patients undergoing shock wave lithotripsy (SWL). In patients with kidney stones, serum urea and creatinine (Cr), urine Cr and NGAL levels were determined immediately before and at 3, 24 h and 30 days after SWL. Urine NGAL concentrations were normalized to urinary Cr ruling out the confounding effect of variable hydration states. Thirty-five patients with a single renal stone were enrolled. Inclusion criteria were: first SWL treatment for each patient, single radiopaque renal stone <20 mm; normal renal function. Exclusion criteria were: body mass index (BMI) > 30 kg/m, recent episodes of renal colic (less than 3 months), the presence of radiolucent stones, renal impairment, upper urinary tract obstruction or malignancy, acute pyelonephritis, patients who consumed potentially nephrotoxic drugs within 4 weeks before the evaluation. Geometric means of urinary NGAL/Cr ratio measured 3 h after SWL were significantly higher than baseline values (difference 7.56 ng/mg, 95% confidence interval 1.61, 13.51; p value = 0.013). No changes were found for urinary NGAL/Cr measured at 24 h (p value = 0.92) and at 30 days (p value = 0.13) after SWL compared with baseline values. Urinary NGAL levels increase soon after SWL (3 h) and quickly return to and maintain basal levels (1 and 30 days). Further studies are necessary to understand the hypothetical role of NGAL as a guide to the degree of tissue injury after SWL.

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Extracorporeal piezoelectric shock wave lithotripsy as mono and multiple therapy of large renal calculi including staghorn stones in unanaesthetized patients under semi‐ambulant conditions

Abstract: We consider semi-ambulant EPL monotherapy to be a minimally invasive alternative treatment in patients with large renal calculi, including staghorn stones.

Cited by 10 publications

References 19 publications

Predictors of Success After Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Calculi Between 20-30mm: A Multivariate Analysis Model

Predictors of Success After Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Calculi Between 20-30mm: A Multivariate Analysis Model

Review of the Clinical Guidelines for Staghorn Calculi

Neutrophil gelatinase-associated lipocalin (NGAL) value changes before and after shock wave lithotripsy

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