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Subject Area

Urology

Article Type

Original Study

Abstract

Objectives The aim of the study was to assess the effect of Hounsfield unit (HU) of renal stones and skin-to-stone distance (SSD) detected by noncontrast computed tomography on the outcome of extracorporeal shock wave lithotripsy (ESWL). Background Urolithiasis is a worldwide health problem with renal stones being the most prevalent entity. ESWL proved to be an efficient modality to treat renal stones. Optimizing stone and patient factors is mandatory to maximize the success rate. Patients and methods In all, 60 patients with renal stones were prospectively enrolled between December 2017 and December 2019. All patients were treated by ESWL using an electromagnetic Dornier lithotripter. Patients were divided into four groups: group 1 with HU less than 1000 HU and SSD less than 10 cm, group 2 with HU less than 1000 HU and SSD more than 10 cm, group 3 with HU more than 1000 HU and SSD less than 10 cm, and group 4 with HU more than 1000 HU and SSD more than 10 cm. All patients were evaluated 2 weeks after each ESWL session with plain kidney-ureter-bladder (KUB) and noncontrast computed tomography. Results Groups 1 and 3 showed 100% stone-free rate, which were nonsignificant to each other or to group 2 (86%). In group 4, the stone-free rate was 80% which was significantly lower than that in groups 1 and 3 but not group 2. HU and SSD were found to be significantly correlated to the number of ESWL sessions. Conclusion HU and SSD are essential predictive factors of ESWL success. Renal stones with HU more than 1000 and/or SSD more than 10 cm should be addressed by treatment other than ESWL.

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