Ultrasound-guided ESWL may be first treatment choice for distal ureteral stones

The study aimed to analyze the factors influencing the efficacy of ultrasound-guided extracorporeal shockwave lithotripsy (ESWL) in the treatment of ureteral stones. The clinical data of 8102 patients (6083 men and 2019 women) who presented with ureteral stones were retrospectively analyzed. All the patients were treated with ultrasound-guided ESWL.

The stone-free rate (SFR) was calculated to evaluate the effect of ESWL. The characteristics of the patients and their stones, and the ESWL parameters applied were compared to identify the factors affecting the treatment outcomes. The SFR and that following one ESWL session were 94.6% (7663/8102) and 75.4% (6107/8102), respectively. Multivariate analysis showed that stone location (OR 0.656, p < 0.001), stone size (OR 1.103, p < 0.001), and degree of hydronephrosis (OR 1.952, p < 0.001) independently affected SFR; and age (OR 1.005, p = 0.022), stone location (OR 0.729, p < 0.001), stone size (OR 1.103, p < 0.001), degree of hydronephrosis (OR 1.387, p = 0.001), maximum energy level(OR 0.691, p < 0.001) independently affected SFR following one session. Ultrasound-guided ESWL is effective in all levels of ureteral stones.

Large stone size and moderate hydronephrosis are correlated with treatment failure. Ultrasound-guided ESWL may be the first choice for distal ureteral stones.

While analyzing the efficacy of ultrasound-guided ESWL for ureteral stones, researchers identified stone location, size, and the degree of hydronephrosis as independent factors influencing overall stone-free rates (SFR). Age, stone location, size, degree of hydronephrosis, and maximum energy level affected SFR after one ESWL session. Distal ureteral stones showed positive outcomes across all levels

Reference:

Liang, J., Xie, L., Gao, H. et al. Factors influencing the efficacy of ultrasound-guided extracorporeal shockwave lithotripsy in the treatment of ureteral stones: a retrospective study. Urolithiasis 52, 15 (2024). https://doi.org/10.1007/s00240-023-01512-9

Keywords:

Ultrasound-guided, ESWL, may be, first, treatment, choice, for, distal, ureteral stones,Liang, J., Xie, L., Gao, H