Renal Stone Features Are More Important Than Renal Anatomy to Predict Shock Wave Lithotripsy Outcomes: Results from a Prospective Study with CT Follow-Up

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTORRICELLI, Fabio C. M.
dc.contributor.authorMONGA, Manoj
dc.contributor.authorYAMAUCHI, Fernando I.
dc.contributor.authorMARCHINI, Giovanni S.
dc.contributor.authorDANILOVIC, Alexandre
dc.contributor.authorVICENTINI, Fabio C.
dc.contributor.authorBATAGELLO, Carlos A.
dc.contributor.authorSROUGI, Miguel
dc.contributor.authorNAHAS, William C.
dc.contributor.authorMAZZUCCHI, Eduardo
dc.date.accessioned2020-03-24T14:54:45Z
dc.date.available2020-03-24T14:54:45Z
dc.date.issued2020
dc.description.abstractIntroduction: Lower pole kidney stones have been associated with poor shock wave lithotripsy (SWL) outcomes because of its location. However, the real impact of collecting system anatomy on stone clearance after SWL is uncertain. There is a lack of prospective well-controlled studies to determine whether lower pole kidney stones have inferior outcomes than nonlower pole kidney stones when treated with SWL. Methods: We prospectively evaluated patients with a single kidney stone of 5-15mm undergoing SWL from June 12 through January 19. All patients were subjected to computed tomography before and 3 months after the procedure. Demographic data (age, gender, and body mass index), stone features (stone size, stone area, stone density, and stone-skin distance-SSD), and collecting system anatomy (infundibular length and width, and infundibulopelvic angle) were recorded. Outcomes (fragmentation and stone clearance rates) were compared between lower pole and nonlower pole cases. Then, a multivariate analysis including all variables was performed to determinate which parameters significantly impact on SWL outcomes. Results: One hundred and twenty patients were included in the study. Mean stone size was 8.3mm and mean stone density was 805 Hounsfield units. Overall stone fragmentation, success, and stone-free rates were 84.1%, 64.1%, and 34.1%, respectively. There were no significant differences in stone fragmentation (76.0% vs 71.4%; p=0.624), success rate (57.6% vs 53.3%; p=0.435), and stone-free rate (40.2% vs 35.7%; p=0.422) in the lower vs nonlower pole groups, respectively. On multivariate analysis, only stone density (p<0.001) and SSD (p=0.006) significantly influenced fragmentation. Stone size (p=0.029), stone density (p=0.002), and SSD (p=0.049) significantly influenced kidney stone clearance. Conclusions: Stone size, stone density, and SSD impact on SWL outcomes. Lower pole kidney stones have similar fragmentation and stone clearance compared with nonlower pole kidney stones.eng
dc.description.indexMEDLINEeng
dc.identifier.citationJOURNAL OF ENDOUROLOGY, v.34, n.1, p.63-67, 2020
dc.identifier.doi10.1089/end.2019.0545
dc.identifier.eissn1557-900X
dc.identifier.issn0892-7790
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/35630
dc.language.isoeng
dc.publisherMARY ANN LIEBERT, INCeng
dc.relation.ispartofJournal of Endourology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright MARY ANN LIEBERT, INCeng
dc.subjectanatomyeng
dc.subjectcomputed tomographyeng
dc.subjectkidneyeng
dc.subjectlithotripsyeng
dc.subjecturinary calculieng
dc.subject.otherpole pelvicaliceal anatomyeng
dc.subject.otherrandomized-trialeng
dc.subject.otherclearanceeng
dc.subject.otherureteroscopyeng
dc.subject.othermanagementeng
dc.subject.othernephrolithiasiseng
dc.subject.otherdiseaseeng
dc.subject.othertrendseng
dc.subject.otherimpacteng
dc.subject.othereswleng
dc.subject.wosUrology & Nephrologyeng
dc.titleRenal Stone Features Are More Important Than Renal Anatomy to Predict Shock Wave Lithotripsy Outcomes: Results from a Prospective Study with CT Follow-Upeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus8
hcfmusp.contributor.author-fmusphcFABIO CESAR MIRANDA TORRICELLI
hcfmusp.contributor.author-fmusphcFERNANDO IDE YAMAUCHI
hcfmusp.contributor.author-fmusphcGIOVANNI SCALA MARCHINI
hcfmusp.contributor.author-fmusphcALEXANDRE DANILOVIC
hcfmusp.contributor.author-fmusphcFABIO CARVALHO VICENTINI
hcfmusp.contributor.author-fmusphcCARLOS ALFREDO BATAGELLO
hcfmusp.contributor.author-fmusphcMIGUEL SROUGI
hcfmusp.contributor.author-fmusphcWILLIAM CARLOS NAHAS
hcfmusp.contributor.author-fmusphcEDUARDO MAZZUCCHI
hcfmusp.description.beginpage63
hcfmusp.description.endpage67
hcfmusp.description.issue1
hcfmusp.description.volume34
hcfmusp.origemWOS
hcfmusp.origem.pubmed31595801
hcfmusp.origem.scopus2-s2.0-85078341880
hcfmusp.origem.wosWOS:000497707400001
hcfmusp.publisher.cityNEW ROCHELLEeng
hcfmusp.publisher.countryUSAeng
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