Triple D Score Is a Reportable Predictor of Shockwave Lithotripsy Stone-Free Rates

Tran, Tim; McGillen, Kathryn L.; Cone, Eugene B.; Pareek, Gyan

doi:10.1089/end.2014.0212

Cited by 66 publications

(66 citation statements)

References 20 publications

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“…Ours was a retrospective, non-randomized, patient/surgeon-driven treatment study, but as the study was initiated after the completion of all patient encounters there was no overt selection bias. Although we strongly support consideration of traditional risk factors for SWL failure (high Hounsfield density of stone, high stone-to-skin distance) [15,16] when choosing treatment modality and employ them informally in patient counseling, we did not formally include them in our choice of treatment. An additional limitation is that a single urologist performed all of the URS procedures versus multiple urologists performing SWL.…”

Section: Discussionmentioning

confidence: 95%

Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

et al. 2016

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This retrospective study revealed superior SFR for ureteral stones less than 1.5 cm treated with URS compared to SWL. Our decision analysis model demonstrated that when SFR for SWL is less than 60-64 % or is greater than 57-76 % for URS, SWL is not a cost-effective treatment option. Based on these findings, careful stratification and selection of stone patients may enable surgeons to increase the cost-effectiveness of SWL.

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Section: Discussionmentioning

confidence: 95%

Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

et al. 2016

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“…For SWL, factors affecting the SFR include stone density and skin‐to‐stone distance values The stone density can be measured using HU. Clinical algorithms for the prediction of upper ureteric stone and renal stones, such as the Triple D scoring system, have been developed to define the most appropriate cases for SWL application For PCNL, Okunov et al . developed a novel surgical classification system for kidney calculi, namely S.T.O.N.E.…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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“…They established cutoffs of <150 μL for ellipsoid stone volume, <12 cm for SSD, and <600HU for stone density. A Triple D Score of 0,1, 2, and 3 correlated with SWL success rates of 21.4%, 41.3%, 78.7%, and 96.1%, respectively [25]. …”

Section: Stone Compositionmentioning

confidence: 99%

Recent advances in lithotripsy technology and treatment strategies: A systematic review update

Elmansy

Lingeman

2016

International Journal of Surgery

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Introduction Shock wave lithotripsy (SWL) is a well – established treatment option for urolithiasis. The technology of SWL has undergone significant changes in an attempt to better optimize the results while reducing failure rates. There are some important limitations that restrict the use of SWL. In this review, we aim to place these advantages and limitations in perspective, assess the current role of SWL, and discuss recent advances in lithotripsy technology and treatment strategies. Methods A comprehensive review was conducted to identify studies reporting outcomes on ESWL. We searched for literature (PubMed, Embase, Medline) that focused on the physics of shock waves, theories of stone disintegration, and studies on optimising shock wave application. Relevant articles in English published since 1980 were selected for inclusion. Results Efficacy has been shown to vary between lithotripters. To maximize stone fragmentation and reduce failure rates, many factors can be optimized. Factors to consider in proper patient selection include skin – to – stone distance and stone size. Careful attention to the rate of shock wave administration, proper coupling of the treatment head to the patient have important influences on the success of lithotripsy. Conclusion Proper selection of patients who are expected to respond well to SWL, as well as attention to the technical aspects of the procedure are the keys to SWL success. Studies aiming to determine the mechanisms of shock wave action in stone breakage have begun to suggest new treatment strategies to improve success rates and safety.

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Triple D Score Is a Reportable Predictor of Shockwave Lithotripsy Stone-Free Rates

Abstract: Readily available predictive tools are necessary to enhance SWL cost-effectiveness. The Triple D Score is simple to calculate and can be reported by radiologists. Incorporation of the Triple D Score into preoperative planning may increase the overall SWL success rates.

Cited by 66 publications

References 20 publications

Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

Cost-effectiveness comparison of ureteral calculi treated with ureteroscopic laser lithotripsy versus shockwave lithotripsy

The Urological Association of Asia clinical guideline for urinary stone disease

Recent advances in lithotripsy technology and treatment strategies: A systematic review update

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