Impact of stone density and size on the effect of flexible ureterorenoscopy with laser lithotripsy
Authors:
Iveta Štrajtová; Peter Dančík; Rostislav Kuldan
Authors‘ workplace:
Městská nemocnice, Ostrava
Published in:
Ces Urol 2018; 22(3): 188-196
Category:
Original Articles
Overview
Introduction:
Flexible ureterorenoscopy (URS) is an endoscopic method which allows visualization of the urinary tract into the kidney in a minimally invasive way. It also allows us to remove stones with using laser and extraction baskets. At present, the knowledge about the impact of stone density on the effect of laser lithotripsy is insufficient. Most previous work deals with a possible prediction of shock wave lithotripsy (ESWL) success.
Purpose:
The aim of this work is to evaluate the possible influence of stone density in Hounsfield units (HU) on CT scans on the result of flexible URS with laser lithotripsy. Also, the influence of cumulative stone size of specific nephroliths is evaluated.
Methods:
For the work, we compiled a total of 109 patients which have undergone the flexible URS for nephrolithiasis in our department since September 2008 to January 2016. In these patients, CT scans had been preoperatively obtained and also cumulative stone size and density in HU had been measured. After the surgery, the result was recorded with using peroperative process, ultrasonography and X‑ray imaging. Subjects were divided into 3 groups according to surgery results. In these groups, the correction by initial stone size was made. The endoscopy results were also connected with stone size.
Results:
The results of the flexible URS varied depending on the size groups. There was not a correlation between the resultant surgery effect and the initial density. After recalculating the results in the individual size groups we also didn’t record any connection in the studied relationship. When we focus on the stone size, we have noticed a significant relationship in terms of indirect proportion. Conclusion: By evaluating the whole patient group after flexible URS, we didn’t demonstrate a significant relationship between stone density in HU and the surgery effect. On the contrary, we confirmed the correlation between the stone cumulative size and endoscopy results.
KEY WORDS
Flexible ureterorenoscopy, stone density, stone size.
Sources
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Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2018 Issue 3
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