Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy
The purpose of this study was to investigate the impact of hydronephrosis on the treatment outcome of patients with a solitary proximal ureteral stone after extracorporeal shock wave lithotripsy (ESWL). A total of 182 consecutive patients who underwent ESWL for a solitary proximal ureteral stone of...
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2008-10-01
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doaj-153a7b6f0b304b7d96333cbcf7e28dff2020-11-24T21:26:39ZengWileyKaohsiung Journal of Medical Sciences1607-551X2008-10-01241050751310.1016/S1607-551X(09)70009-9Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave LithotripsyHsi-Lin Hsiao0Shu-Pin Huang1Wen-Jeng Wu2Yung-Chin Lee3Wei-Ming Li4Yii-Her Chou5Ai-Wen Chang6Chun-Hsiung Huang7Shu-Chin Sun8Chia-Chu Liu9Department of Urology, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanThe purpose of this study was to investigate the impact of hydronephrosis on the treatment outcome of patients with a solitary proximal ureteral stone after extracorporeal shock wave lithotripsy (ESWL). A total of 182 consecutive patients who underwent ESWL for a solitary proximal ureteral stone of between 5 and 20 mm in size in our institution were included in this study. The degree of hydronephrosis was defined by renal ultrasonography. Patient data, stone size, shock wave numbers and shock wave energy were also recorded. Treatment outcome was evaluated 3 months after the first session of ESWL. In multivariate analysis, only the maximal stone length (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.03–0.91; p = 0.04) and the degree of hydronephrosis (OR, 0.40; 95% CI, 0.16–0.98; p = 0.045) were significant predicting factors for stone-free status 3 months after ESWL. For stones ≤ 10 mm, the stone-free rate decreased from 80% in patients with mild hydronephrosis to 56.4% in those with moderate to severe hydro-nephrosis. For stones > 10 mm, the stone-free rate decreased further, from 65.2% in patients with mild hydronephrosis to 33.3% in those with moderate to severe hydronephrosis. In summary, patients with a solitary proximal ureteral stone and a stone > 10 mm, the treatment outcome after ESWL was not good if moderate to severe hydronephrosis was noted on ultrasonography. Alternative treatments, such as ureteroscopic lithotripsy, may be appropriate as initial treatment or after failure of one session of ESWL.http://www.sciencedirect.com/science/article/pii/S1607551X09700099ESWLhydronephrosisproximal ureterultrasonographyurolithiasis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hsi-Lin Hsiao Shu-Pin Huang Wen-Jeng Wu Yung-Chin Lee Wei-Ming Li Yii-Her Chou Ai-Wen Chang Chun-Hsiung Huang Shu-Chin Sun Chia-Chu Liu |
spellingShingle |
Hsi-Lin Hsiao Shu-Pin Huang Wen-Jeng Wu Yung-Chin Lee Wei-Ming Li Yii-Her Chou Ai-Wen Chang Chun-Hsiung Huang Shu-Chin Sun Chia-Chu Liu Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy Kaohsiung Journal of Medical Sciences ESWL hydronephrosis proximal ureter ultrasonography urolithiasis |
author_facet |
Hsi-Lin Hsiao Shu-Pin Huang Wen-Jeng Wu Yung-Chin Lee Wei-Ming Li Yii-Her Chou Ai-Wen Chang Chun-Hsiung Huang Shu-Chin Sun Chia-Chu Liu |
author_sort |
Hsi-Lin Hsiao |
title |
Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy |
title_short |
Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy |
title_full |
Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy |
title_fullStr |
Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy |
title_full_unstemmed |
Impact of Hydronephrosis on Treatment Outcome of Solitary Proximal Ureteral Stone After Extracorporeal Shock Wave Lithotripsy |
title_sort |
impact of hydronephrosis on treatment outcome of solitary proximal ureteral stone after extracorporeal shock wave lithotripsy |
publisher |
Wiley |
series |
Kaohsiung Journal of Medical Sciences |
issn |
1607-551X |
publishDate |
2008-10-01 |
description |
The purpose of this study was to investigate the impact of hydronephrosis on the treatment outcome of patients with a solitary proximal ureteral stone after extracorporeal shock wave lithotripsy (ESWL). A total of 182 consecutive patients who underwent ESWL for a solitary proximal ureteral stone of between 5 and 20 mm in size in our institution were included in this study. The degree of hydronephrosis was defined by renal ultrasonography. Patient data, stone size, shock wave numbers and shock wave energy were also recorded. Treatment outcome was evaluated 3 months after the first session of ESWL. In multivariate analysis, only the maximal stone length (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.03–0.91; p = 0.04) and the degree of hydronephrosis (OR, 0.40; 95% CI, 0.16–0.98; p = 0.045) were significant predicting factors for stone-free status 3 months after ESWL. For stones ≤ 10 mm, the stone-free rate decreased from 80% in patients with mild hydronephrosis to 56.4% in those with moderate to severe hydro-nephrosis. For stones > 10 mm, the stone-free rate decreased further, from 65.2% in patients with mild hydronephrosis to 33.3% in those with moderate to severe hydronephrosis. In summary, patients with a solitary proximal ureteral stone and a stone > 10 mm, the treatment outcome after ESWL was not good if moderate to severe hydronephrosis was noted on ultrasonography. Alternative treatments, such as ureteroscopic lithotripsy, may be appropriate as initial treatment or after failure of one session of ESWL. |
topic |
ESWL hydronephrosis proximal ureter ultrasonography urolithiasis |
url |
http://www.sciencedirect.com/science/article/pii/S1607551X09700099 |
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