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Is extracorporeal shockwave lithotripsy (SWL) still suitable for >1.5 cm intrarenal stones? Data analysis of 1902 SWLs.
Azal Neto, Wilmar; Morales, Enzo; Joseane Pachecco, Marina; Pedro, Renato Nardi; Reis, Leonardo O.
Afiliação
  • Azal Neto W; UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, Brazil.
  • Morales E; Medicine, Faculdade São Leopoldo Mandic, Campinas, Brazil.
  • Joseane Pachecco M; Medicine, Faculdade São Leopoldo Mandic, Campinas, Brazil.
  • Pedro RN; Endourology Section, University of Campinas and AME/SBO Lithotripsy Center - UNICAMP, Campinas, Brazil.
  • Reis LO; UroScience, University of Campinas and Pontifical Catholic University of Campinas, Campinas, Brazil.
Scand J Urol ; 55(5): 388-393, 2021 Oct.
Article em En | MEDLINE | ID: mdl-34279162
PURPOSE: According to the American Urological Association and European Association of Urology guidelines, shockwave lithotripsy (SWL) is the least-invasive treatment option for kidney stones smaller than 2 cm. However, it is well known that SWL stone-free rates (SFR) decline as stone size increases. We sought to evaluate whether the size limit of 1.5 cm could be a better predictor of success after a single SWL session than current recommendations. METHODS: Data from an SWL-dedicated center were prospectively scrutinized according to stone locations and sizes. Information on patients' demography, lithotripsy parameters, and outcomes was evaluated by multivariate analysis among 1902 SWLs. RESULTS: The overall SFR was 70.8% (1347/1902). SFRs according to stone size were <1 cm: 73.8% (825/1118), 1-1.5 cm: 70.4% (401/569) and >1.5 cm: 56.2% (121/215); and according to calculi location were lower pole (LP) 64.4% (398/618), mid pole 73.8% (339/459), upper pole 73.8% (273/370) and renal pelvis 74.1% (337/455). Multivariate analysis revealed better SFR independent better SFR in <1.5 cm (p < 0.01), and non-LP stones (p < 0.01). CONCLUSION: SWL is an effective treatment modality for kidney stones. The single session reached up to 74.8% SFRs (range 70.8%-74.8%) when indicated for intrarenal non LP stones smaller than 1.5 cm. Patients with stones >1.5 cm or >1 cm located in the LP should be counseled on the lower SFRs after a single SWL session.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Litotripsia / Cálculos Renais Tipo de estudo: Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Scand J Urol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suécia
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Litotripsia / Cálculos Renais Tipo de estudo: Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Scand J Urol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suécia