Clinical predictors of stone fragmentation using slow-rate shock wave lithotripsy.
OBJECTIVE
To determine efficacy and clinical predictors of stone fragmentation when using slow-rate shock wave lithotripsy (SWL).


METHODS
In total, 116 patients with radiopaque urinary tract stones were randomized into two groups: 57 patients were treated with SWL at 90 shocks/min, and 59 patients were treated with SWL at 120 shocks/min. The efficacy of SWL was evaluated within 1 month after treatment. Patient characteristics, features of stones, and SWL conditions were reviewed. Success rates relating to individual parameters were assessed by using chi-square and Student t tests. All factors were further entered into multivariate logistic regression analysis.


RESULTS
There were no statistically significant differences between the two groups with regard to age, sex, site and size of the stones, renal function, and total number of shock waves. In univariate analysis, the success rate was significantly related to shock wave frequency (p = 0.023), length and width of the stones (p < 0.001), total number of shock waves (p = 0.047), and age (p = 0.049). In multivariate analysis, however, only shock wave rate and stone length remained statistically significant (p = 0.021 and p = 0.046, respectively). The overall success rate was significantly higher in the group treated with 90 shocks/min (p = 0.02). However, this higher success rate was statistically significant only in patients with a stone length > or = 10 mm (50.0 vs. 18.5%, p = 0.019).


CONCLUSIONS
SWL at 90 shocks/min yielded better outcomes than SWL at 120 shocks/min, particularly in patients with stone lengths > or = 10 mm.
Li
Wei-Ming
WM
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Wu
Wen-Jeng
WJ
Chou
Yii-Her
YH
Liu
Chia-Chu
CC
Wang
Chii-Jye
CJ
Huang
Chun-Hsiung
CH
Lee
Yung-Chin
YC
D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019233:Retreatment; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*