Prognostic factors for the success of extracorporeal shock wave lithotripsy
Authors:
K. Fógel; T. Hanuš; K. Novák
Authors‘ workplace:
Přednosta: prof. MUDr. Tomáš Hanuš, DrSc.
; Univerzity Karlovy, Praha
; Urologická klinika
; Všeobecná fakultní nemocnice a 1. lékařská fakulta
Published in:
Prakt. Lék. 2009; 89(12): 663-667
Category:
Reviews
Overview
Since its invention in the 1980s and subsequent introduction into clinical practice, Extracorporeal Shock Wave Lithotripsy (ESWL) has dramatically changed the previous, rather invasive, approach to the treatment of urinary stones. Up to 90 % of patients with kidney stones now undergo ESWL. There has been a lot of data published on this topic over the past twenty-nine years. From this amount of evidence, we can identify the specific prognostic factors, which can be used to predict the clinical outcome of the shock wave lithotripsy, thus providing for the better selection of patients. Two main groups of factors are thought to have the strongest prediction value: patient-dependent and the machine and operator/dependent factors. Patient factors include: location, size, stone burden, computerized tomography (CT) density and chemical composition, stone-to-skin distance, body mass index (BMI), presence of a JJ-stent, age, congenital or acquired urinary tract anomalies and use of medical expulsion drugs. Machine-dependent factors are: shock wave frequency, type of lithotripter, bubbleless coupling, type of anaesthesia and operator experience.
Key words:
extracorporeal shock wave lithotripsy, prognostic factors, urinary stones.
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