Outcome of extracorporeal shock wave lithotripsy for renal and upper ureteric stone clearance

ESWL for renal and upper ureteric stone

Abstract

Introduction: Extracorporeal shockwave lithotripsy (ESWL) is a daycare, less invasive procedure not requiring anesthesia for the treatment of renal and ureteric stones. 

 Method: This was a cross-sectional study of retrospectively collected data on ESWL from May 2018 to January 2020 at the department of Urology, Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal. The data on ESWL for renal and upper ureteric stones up to 20 mm were included. Stone clearance was defined as stone fragment <4 mm on kidney ureter bladder (KUB) X-ray or ultrasonography (USG) during follow-up at 1 - 3 mo. Ethical approval was obtained from NAMS ethical committee. Microsoft Excel was used for descriptive analysis of age, gender, stone size, density, location, hydronephrosis, and clearance. A Chi-square test was used for the association, and a p-value <0.05 was considered statistically significant.

 Result: Out of 79 cases, overall stone clearance was 48(60.8%), 100% for <10 mm (14/14) and density <500 HU (5/5), and 80% for upper ureteric stone (4/5) and 74.1% for those without hydronephrosis (20/27). Patients in the age group of 20-39 y accounted for 48(60.8%), males 52(65.8%), 52(65%) had 10-15 mm stones, 46(58.2%) in the pelvis, 48(60.8%) density of 751-1000 HU, and mild hydronephrosis present in 44(55.7%).

 Conclusion: Stone clearance was highest (100%) for small stones <10 mm in size and low density <500 HU. The stone clearance rate decreased as the size, density, and hydronephrosis increased.

Keywords: extracorporeal shock lithotripsy, hydronephrosis, renal and upper ureteric stone, stone clearance, stone size, and density