EAU 2018: S Early Extracorporeal Shock Wave Lithotripsy Useful For Colic Patients With Ureteral Stones? A Guide To Effective Early Extracorporeal Shock Wave Lithotripsy?
In this study, 335 patients, suffering from stone-related renal colic, received lithotripsy for ureteral stones. In order to analyze the sensitivity and specificity of the cut-off point for early success, the team attempted to identify the critical cut-off point about the time to extracorporeal shock wave lithotripsy (ESWL). Patient demographics and perioperative data including ESWL success rate, age, gender, BMI, comorbidity, serum creatinine, stone size, stone location, stone laterality, Hounsfield units, presence of hydronephrosis, and presence of tissue rim were collected. Univariate, multivariate, and subgroup analyses were carried out on all aforementioned variables. Patients were categorized into two groups: whether the patient underwent ESWL early or if they deferred ESWL until a later time.
Following data analysis from the surgical and postoperative findings of these patients, it was found that number of ESWL shocks, time to stone free rate, and rate of stone free within 1 month was all statistically significant in favor of the early ESWL cohort. This is a clear indication that patients should be treated earlier with ESWL if they are experiencing symptoms of ureteral colic. Dr. Kim concluded his presentation by recommending to the audience that early lithotripsy be conducted in pateitns who are ≤65 years old, have a Hounsfield unit of ≤815, stone size ≤10 mm, or mid to distal stone location.
Speaker: Chang Hee Kim
Authors: Kim C. , Kwang Taeck K. , Jin Kyu O. , Kyung Jin C. , Tae Beom K. , Khae Hawm K. , Han J. , Sang Jin Y.
Written by: Zachary Valley, Department of Urology, University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark