Comparison of clinical outcome of extracorporeal shockwave lithotripsy in patients with radiopaque v radiolucent ureteral calculi.
OBJECTIVE
To compare the efficacy of extracorporeal shockwave lithotripsy (SWL) in patients with radiopaque and radiolucent ureteral calculi.


METHODS
Between September 2001 and August 2002, a total of 113 consecutive patients with ureteral calculi (58 radiopaque [Group 1], 55 radiolucent [Group 2]) were treated with a Multimed 2001 trade mark lithotripter under fluoroscopic monitoring. Localization of radiolucent stones was achieved after a bolus injection of contrast medium 1 mL/kg, the shockwaves being focused just below the end of contrast column. All patients were treated on an outpatient basis under analgesia and light sedation if required. The mean follow-up was 14 (range 6-23) months. Patients were reevaluated by some combination of plain films, ultrasound scanning, and intravenous urography 3 months after the treatment. Groups were compared with ANOVA and Mann-Whitney U tests. A P value <0.05 was regarded as statistically significant.


RESULTS
There were no statistically significant differences in any parameter between groups. At 3 months, the success rate (stone-free status) was 87.9% in Group 1 and 89% in Group 2 (P = 0.848). Double-J catheter replacement was needed for three patients in Group 1 and for two patients in Group 2 (P = 0.693). Two patients from Group 1 and three from Group 2 underwent intracorporeal lithotripsy with ureterorenoscopy (P = 0.606). No adverse reactions to contrast medium occurred in Group 2.


CONCLUSIONS
Patients with radiolucent ureteral calculi can be treated efficiently with SWL by contrast medium injection if ultrasonic localization is not possible.
Cimentepe
Ersin
E
Department of Urology, Fatih University School of Medicine, Ciftlik Cd No: 57, 06510 Emek, Ankara, Turkey. ersincimentepe@yahoo.com
Unsal
Ali
A
Saglam
Remzi
R
Balbay
M Derya
MD
D000328:Adult; D000704:Analysis of Variance; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D014514:Ureteral Calculi / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods; D014567:Urography / Q000379:methods
D003287:Contrast Media; D019275:Radiopharmaceuticals