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Minerva Urology and Nephrology 2021 Mar 29

DOI: 10.23736/S2724-6051.21.04278-8


language: English

Can shock wave lithotripsy lead to impaction of ureteral stones?

Fatih AKKAS 1 , Emre SAM 1, Ali AYTEN 2, Feyzi A. ATAR 2, Ekrem GUNER 2

1 Department of Urology, Erzurum Training and Research Hospital, Health Sciences University Erzurum, Turkey; 2 Department of Urology, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul, Turkey


BACKGROUND: One of the underlying reasons for shock wave lithotripsy (SWL)-resistance is the ureteral stone's impaction. This study aimed to investigate the accuracy of the hypothesis, suggesting that SWL per se can be the reason for ureteral stone impaction.
METHODS: One hundred and seventy-six patients were enrolled in the study. Data of the patients (n=50) treated with SWL and subsequent semirigid ureteroscopic laser lithotripsy (SULL) in our center between January 2014 and January 2020 were retrospectively reviewed compared with the data of the patients (n=126) who underwent SULL without prior SWL treatment during the same period. Patients reported to have ureteral stone impaction during SULL were compared with those without stone impaction in terms of demographic parameters, stone characteristics, and clinical data, including symptom duration and presence or absence of SWL history.
RESULTS: The success rate of SULL was determined as 80.1% (141/176). Univariable analysis revealed statistically significant differences between the patients with and without stone impaction concerning stone diameter, stone volume, pre-SULL SWL history, symptom duration, and ureteral wall thickness (UWT). Multivariable logistic regression analysis revealed that symptom duration and UWT were independent predictive factors for ureteral stone impaction.
CONCLUSIONS: Symptom duration and UWT are independent predictors of ureteral stone impaction. Symptom duration and UWT should be considered during treatment planning and informed consent process before proceeding with SULL.

KEY WORDS: Ureteral stone; Impacted stone; Shock wave lithotripsy

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