Factors associated with failure of extracorporeal shock-wave lithotripsy for ureteral stones using Dornier lithotripter U/50.
BACKGROUND
In the present series of 170 patients who underwent extracorporeal shock-wave lithotripsy (SWL) treatment for ureteral stones, the authors determine which patients with ureteral stones had an unsuccessful outcome.


METHODS
The records of 170 patients with ureteral stones who were treated with SWL using the Dornier lithotriptor U/50 (EMSE 140) between January 1998 and December 1999 were retrospectively investigated. One hundred and thirty-one patients were treated with SWL alone (single session, n = 98; multiple session, n = 33) and 39 patients required auxiliary treatment due to failure of SWL (33 with transurethral ureterolithotripsy (TUL), one with open lithotomy, and five with residual fragments who were followed up). These two groups were compared using multivariate logistic regression analysis.


RESULTS
Lower ureteral stones and stones more than 12 mm in diameter were associated with a poor outcome of SWL. There were no significant differences in age, gender, number of stones, JJ stent placement, and degree of ureteral obstruction due to the stone between the two groups. The odds ratios of lower ureteral stones and stones > or = 12 mm were 4.18 and 2.57, respectively.


CONCLUSIONS
Patients with distal ureteral stones and/or stones more than 12 mm in diameter were difficult to treat successfully with SWL. Alternatives such as TUL should possibly be considered as a first-line therapy for these stones.
Department of Urology, Kidney Center, Tokyo Women's Medical University, Japan. yshiro@kc.twmu.ac.jp
Yoshiyuki
Y
Shiroyanagi
Takashi
T
Yagisawa
Masayuki
M
Nanri
Chika
C
Kobayashi
Hiroshi
H
Toma
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D014514:Ureteral Calculi / Q000473:pathology / Q000628:therapy*