Skip to main content
SpringerLink
Log in

Factors influencing the efficacy of ultrasound-guided extracorporeal shockwave lithotripsy in the treatment of ureteral stones: a retrospective study

  • RESEARCH
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

The aim of the study was to analyze the factors influencing the efficacy of ultrasound-guided extracorporeal shockwave lithotripsy (ESWL) in the treatment of ureteral stones. The clinical data of 8102 patients (6083 men and 2019 women) who presented with ureteral stones were retrospectively analyzed. All the patients were treated with ultrasound-guided ESWL. The stone-free rate (SFR) was calculated to evaluate the effect of ESWL. The characteristics of the patients and their stones, and the ESWL parameters applied were compared to identify the factors affecting the treatment outcomes. The SFR and that following one ESWL session were 94.6% (7663/8102) and 75.4% (6107/8102), respectively. Multivariate analysis showed that stone location (OR 0.656, p < 0.001), stone size (OR 1.103, p < 0.001), and degree of hydronephrosis (OR 1.952, p < 0.001) independently affected SFR; and age (OR 1.005, p = 0.022), stone location (OR 0.729, p < 0.001), stone size (OR 1.103, p < 0.001), degree of hydronephrosis (OR 1.387, p = 0.001), maximum energy level(OR 0.691, p < 0.001) independently affected SFR following one session. Ultrasound-guided ESWL is effective in all levels of ureteral stones. Large stone size and moderate hydronephrosis are correlated with treatment failure. Ultrasound-guided ESWL may be the first choice for distal ureteral stones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data is available on request by contacting the authors.

References

  1. Ramello A, Vitale C, Marangella M (2000) Epidemiology of nephrolithiasis. J Nephrol 13(Suppl 3):S45-50

    PubMed  Google Scholar 

  2. Qian X, Wan J, Xu J et al (2022) Epidemiological trends of urolithiasis at the global, regional, and national levels: a population-based study. Int J Clin Pract 2022:6807203. https://doi.org/10.1155/2022/6807203

    Article  PubMed  PubMed Central  Google Scholar 

  3. Fink HA, Wilt TJ, Eidman KE et al (2013) Medical management to prevent recurrent nephrolithiasis in adults: a systematic review for an American College of Physicians Clinical Guideline. Ann Intern Med 158(7):535–543. https://doi.org/10.7326/0003-4819-158-7-201304020-00005

    Article  PubMed  Google Scholar 

  4. Antonelli JA, Maalouf NM, Pearle MS et al (2014) Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030. Eur Urol 66(4):724–729. https://doi.org/10.1016/j.eururo.2014.06.036

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rassweiler J, Rieker P, Rassweiler-Seyfried MC (2020) Extracorporeal shock-wave lithotripsy: is it still valid in the era of robotic endourology? Can it be more efficient? Curr Opin Urol 30(2):120–129. https://doi.org/10.1097/mou.0000000000000732

    Article  PubMed  Google Scholar 

  6. Jour I, Lam A, Turney B (2022) Urological stone disease: a 5-year update of stone management using Hospital Episode Statistics. BJU Int. https://doi.org/10.1111/bju.15728

    Article  PubMed  Google Scholar 

  7. Rassweiler JJ, Tailly GG, Chaussy C (2005) Progress in lithotriptor technology. EAU Updat Ser 3(1):17–36. https://doi.org/10.1016/j.euus.2004.11.003

    Article  Google Scholar 

  8. Neisius A, Lipkin ME, Rassweiler JJ et al (2015) Shock wave lithotripsy: the new phoenix? World J Urol 33(2):213–221. https://doi.org/10.1007/s00345-014-1369-3

    Article  PubMed  Google Scholar 

  9. Skolarikos A, Neisius A, Petřík A, et al (2022) EAU guidelines on urolithiasis. https://uroweb.org/guidelines/urolithiasis. Accessed 16 Sep 2020

  10. Snicorius M, Bakavicius A, Cekauskas A et al (2021) Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection. Wideochir Inne Tech Maloinwazyjne 16(2):409–416. https://doi.org/10.5114/wiitm.2021.103915

    Article  PubMed  PubMed Central  Google Scholar 

  11. Guler Y, Erbin A, Kafkasli A et al (2021) Factors affecting success in the treatment of proximal ureteral stones larger than 1 cm with extracorporeal shockwave lithotripsy in adult patients. Urolithiasis 49(1):51–56. https://doi.org/10.1007/s00240-020-01186-7

    Article  CAS  PubMed  Google Scholar 

  12. Washino S, Hayase T, Miyagawa T et al (2021) Association between time to lithotripsy and stone-free rate in patients with ureteral stones undergoing shock wave lithotripsy. Urolithiasis 49(4):351–358. https://doi.org/10.1007/s00240-020-01232-4

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cleveland RO, Anglade R, Babayan RK (2004) Effect of stone motion on in vitro comminution efficiency of Storz Modulith SLX. J Endourol 18(7):629–633. https://doi.org/10.1089/end.2004.18.629

    Article  PubMed  Google Scholar 

  14. Chang TH, Lin WR, Tsai WK et al (2020) Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones. BMC Urol 20(1):183. https://doi.org/10.1186/s12894-020-00756-6

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chen CJ, Hsu HC, Chung WS et al (2009) Clinical experience with ultrasound-based real-time tracking lithotripsy in the single renal stone treatment. J Endourol 23(11):1811–1815. https://doi.org/10.1089/end.2008.0475

    Article  PubMed  Google Scholar 

  16. Alexander CE, Gowland S, Cadwallader J et al (2016) Shock wave lithotripsy (SWL): outcomes from a national SWL database in New Zealand. BJU Int 117(Suppl 4):76–81. https://doi.org/10.1111/bju.13431

    Article  PubMed  Google Scholar 

  17. Chiang BJ, Liao CH, Lin YH (2017) The efficacy of extracorporeal shockwave lithotripsy for symptomatic ureteral stones: Predictors of treatment failure without the assistance of computed tomography. PLoS ONE 12(9):e0184855. https://doi.org/10.1371/journal.pone.0184855

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Choo MS, Han JH, Kim JK et al (2018) The transgluteal approach to shockwave lithotripsy to treat distal ureter stones: a prospective, randomized, and multicenter study. World J Urol 36(8):1299–1306. https://doi.org/10.1007/s00345-018-2244-4

    Article  PubMed  Google Scholar 

  19. Köse AC, Demirbas M (2004) The ‘modified prone position’ a new approach for treating pre-vesical stones with extracorporeal shock wave lithotripsy. BJU Int 93(3):369–373. https://doi.org/10.1111/j.1464-410X.2004.04619.x

    Article  PubMed  Google Scholar 

  20. Istanbulluoglu MO, Hoscan MB, Tekin MI et al (2011) Shock wave lithotripsy for distal ureteric stones: supine or prone. Urol Res 39(3):177–180. https://doi.org/10.1007/s00240-010-0322-1

    Article  PubMed  Google Scholar 

  21. AbdelRazek M, Hassan A, AbdelKader MS et al (2019) SWL outcome in artificial hydronephrotic vs. non-hydronephrotic kidney for preschool children with high-density renal stones. World J Urol 37(5):937–941. https://doi.org/10.1007/s00345-018-2471-8

    Article  PubMed  Google Scholar 

  22. Hazar IA, Cakiroglu B, Sinanoglu O et al (2018) Does mild hydronephrosis induced by full-bladder improve outcomes in patients undergoing shock wave lithotripsy for lower calyceal stones?: a prospective randomized study. Urol J 15(3):92–95. https://doi.org/10.22037/uj.v0i0.3923

    Article  PubMed  Google Scholar 

  23. Seitz C, Fajkovic H, Waldert M et al (2006) Extracorporeal shock wave lithotripsy in the treatment of proximal ureteral stones: does the presence and degree of hydronephrosis affect success? Eur Urol 49(2):378–383. https://doi.org/10.1016/j.eururo.2005.09.022

    Article  PubMed  Google Scholar 

  24. He Z, Yin S, Duan X et al (2020) Does the presence or degree of hydronephrosis affect the stone disintegration efficacy of extracorporeal shock wave lithotripsy? A systematic review and meta-analysis. Urolithiasis 48(6):517–526. https://doi.org/10.1007/s00240-019-01165-7

    Article  PubMed  Google Scholar 

  25. Chang KD, Lee JY, Park SY et al (2017) Impact of pretreatment hydronephrosis on the success rate of shock wave lithotripsy in patients with ureteral stone. Yonsei Med J 58(5):1000–1005. https://doi.org/10.3349/ymj.2017.58.5.1000

    Article  PubMed  PubMed Central  Google Scholar 

  26. Pareek G, Armenakas NA, Panagopoulos G et al (2005) Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 65(1):33–36. https://doi.org/10.1016/j.urology.2004.08.004

    Article  PubMed  Google Scholar 

  27. Hatiboglu G, Popeneciu V, Kurosch M et al (2011) Prognostic variables for shockwave lithotripsy (SWL) treatment success: no impact of body mass index (BMI) using a third generation lithotripter. BJU Int 108(7):1192–1197. https://doi.org/10.1111/j.1464-410X.2010.10007.x

    Article  PubMed  Google Scholar 

  28. Cho KS, Jung HD, Ham WS et al (2015) Optimal skin-to-stone distance is a positive predictor for successful outcomes in upper ureter calculi following extracorporeal shock wave lithotripsy: a Bayesian model averaging approach. PLoS One 10(12):e0144912. https://doi.org/10.1371/journal.pone.0144912

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Shinde S, Al Balushi Y, Hossny M et al (2018) Factors affecting the outcome of extracorporeal shockwave lithotripsy in urinary stone treatment. Oman Med J 33(3):209–217. https://doi.org/10.5001/omj.2018.39

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The project was supported by Tianjin Key Medical Discipline (Specialty) Construction Project, Sponsored by Tianjin Health Research Project (TJWJ2022ZD004), The Science and Technology Project of Tianjin (21JCYBJC01300), Tianjin Health Science and Technology Project (KJ20152).

Author information

Author notes

  1. Junjie Liang, Linguo Xie, and Hongwei Gao have contributed equally.

Authors and Affiliations

  1. Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Pingjiang Road 23, He Xi District, Tianjin, China

    Junjie Liang, Linguo Xie, Hongwei Gao, Rui Yang, Jinling Liu & Chunyu Liu

Authors
  1. Junjie Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linguo Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hongwei Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rui Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jinling Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chunyu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JL, LX, and HG had equal contributions. JL, LX, and HG contributed to the study conception and design. The first draft of the manuscript was written by JL and all authors commented on previous versions of the manuscript. Data collection was performed by all authors. Data analysis was performed by JL and LX. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chunyu Liu.

Ethics declarations

Conflict of interest

There are no conflicts of interest.

Ethical approval

All ethical standards are complied.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liang, J., Xie, L., Gao, H. et al. Factors influencing the efficacy of ultrasound-guided extracorporeal shockwave lithotripsy in the treatment of ureteral stones: a retrospective study. Urolithiasis 52, 15 (2024). https://doi.org/10.1007/s00240-023-01512-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00240-023-01512-9

Keywords

Search

Navigation