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Three-dimensional mean stone density on non-contrast computed tomography can predict ureteroscopic lithotripsy outcome in ureteral stone cases

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Abstract

The association between mean stone density (MSD) and ureteroscopic lithotripsy outcome remains controversial. MSD automatically measured by 3D images of stones (3D-MSD) was recently reported to be more useful than manual measuring methods for predicting outcomes of shock-wave lithotripsy. This study aims to investigate whether 3D-MSD can predict ureteroscopic lithotripsy outcome. We retrospectively identified 218 patients who underwent ureteroscopic lithotripsy for kidney stones (n = 135) and ureteral stones (n = 83) between February 2011 and April 2017 with pretreatment non-contrast computed tomography (NCCT) at our hospital. Stone volume and 3D-MSD were automatically measured using high functional viewer. Logistic regression analysis was performed to identify factors contributing to treatment failure. Treatment failure was determined as residual fragments ≥ 4 mm using NCCT within 3 months after operation. Treatment failure rate was 20.1% (44/218 cases). Patients in treatment failure group had higher percentage of kidney stones (< 0.01) and multiple stones (p < 0.01), larger stone volume (p < 0.01) and higher 3D-MSD (p < 0.01). Multivariate analysis revealed that stone location (p < 0.01), stone number (p < 0.01), stone volume (p = 0.02) and 3D-MSD (p = 0.02) independently predicted the outcome. Categorized by stone location, 3D-MSD was the only significant independent predictor in cases of ureteral stones (p < 0.01), but was not significant in cases of kidney stones. 3D-MSD is useful for predicting ureteroscopic lithotripsy outcome in cases of ureteral stones.

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Abbreviations

URSL:

Ureteroscopic lithotripsy

MSD:

Mean stone density

SWL:

Shock-wave lithotripsy

3D-MSD:

Three-dimensional mean stone density

NCCT:

Non-contrast computed tomography

BMI:

Body mass index

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Acknowledgements

This document was proofread and edited by Benjamin Phillis at the Clinical Study Support Center at Wakayama Medical University.

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Authors and Affiliations

  1. Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan

    Shimpei Yamashita, Yuya Iwahashi, Ryusuke Deguchi, Kazuro Kikkawa, Yasuo Kohjimoto & Isao Hara

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  1. Shimpei Yamashita
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  2. Yuya Iwahashi
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  3. Ryusuke Deguchi
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  4. Kazuro Kikkawa
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  5. Yasuo Kohjimoto
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  6. Isao Hara
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Correspondence to Shimpei Yamashita.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Yamashita, S., Iwahashi, Y., Deguchi, R. et al. Three-dimensional mean stone density on non-contrast computed tomography can predict ureteroscopic lithotripsy outcome in ureteral stone cases. Urolithiasis 48, 547–552 (2020). https://doi.org/10.1007/s00240-020-01178-7

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  • DOI: https://doi.org/10.1007/s00240-020-01178-7

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