title: Postshockwave lithotripsy outcome evaluation in ureteral stones: comparison between noncontrast computed tomography and plain abdominal radiography.
abstract: OBJECTIVE
  There are no definite data indicating which modality to use to assess the efficacy of shockwave lithotripsy (SWL). Usually, plain abdominal radiography (PAR) is recommended in percutaneous nephrolithotomy (PCNL) afterward and in the follow-up of asymptomatic stones, whereas noncontrast CT (NCCT) is recommended in cases of residual fragments. We compared the efficacies of PAR and NCCT in terms of assessing the outcome of SWL treatment for radiopaque ureteral stones.
  
  
  METHODS
  Those patients with renal colic and a radiopaque ureteral stone of 5 to 20 mm that was detected on PAR were included in the study; body mass index (BMI) values were calculated and recorded. Patients whose PAR revealed opacities suspicious for ureteral stones were evaluated with NCCT at 3-mm slices. Stone status was assessed with PAR and NCCT on post-SWL day 3. Detection of no stone, a residual fragment of ≤ 4 mm, and a residual fragment of >4 mm was defined as success, clinically insignificant residual fragments, and failure, respectively.
  
  
  RESULTS
  On post-SWL day 3, both PAR and NCCT revealed stones in 31 patients, and no stones were seen in either modality in 29 patients. NCCT revealed stones whereas PAR had negative results for stones in two patients. These patients had upper ureteral stones of 7.5 mm (6-9 mm) before SWL. Mean stone size on NCCT after SWL was 2.5 mm (1-4 mm). Mean BMI of these two patients was 27.72, and mean BMI of the patients with upper ureteral stones that were revealed by both PAR and NCCT was 27.68; these two values were statistically similar.
  
  
  CONCLUSIONS
  PAR is capable of detecting clinically significant residual fragments, and patients can be followed up with PAR alone after SWL treatment for radiopaque ureteral stones. This approach both decreases the cost and prevents excessive radiation exposure.
authors.affiliation: Urology Department, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey. hasan_soydan@yahoo.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Soydan
authors.forename: Ilker
authors.initials: I
authors.lastname: Akyol
authors.forename: Temucin
authors.initials: T
authors.lastname: Senkul
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ates
authors.forename: Sami
authors.initials: S
authors.lastname: Uguz
authors.forename: Omer
authors.initials: O
authors.lastname: Yilmaz
authors.forename: Kadir
authors.initials: K
authors.lastname: Baykal
mesh_terms: D003287:Contrast Media; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*
chemical_list: D003287:Contrast Media