ESWL of Solitary Renal Stones at Different Anatomical Sites with Piezoelectric Lithotripsy. Does it Affect the Results?

Refaat Abusamra; Omran Aburgiga; Ali Ben Omran

المؤلفون

Refaat Abusamra Consultant Urologist Department of Urology Ibn Sina teaching Hospital Associate Professor Sirte University Libya
Omran Aburgiga Consultant Urologist Department of Urology Ibn Sina teaching Hospital Lecturer Sirte university Libya
Ali Ben Omran Specialist Urologist Department of Urology the National Cancer Institute Misurata Libya

الكلمات المفتاحية:

von Willebrand disease، type 3، laparoscopic surgery، ; perioperative management، pneumothorax

الملخص

Introduction: Kidney stone disease is a common health problem which increasing prevalence in industrialized countries. Extracorporeal Shockwave Lithotripsy (ESWL) is an important, effective, non-invasive, treatment option for kidney stones.

Aims: This study aimed to investigate the effect of stone location within the kidney on the outcome of ESWL in renal solitary stones.

Methods: A single center study that assessed the effect of stone location inside the kidney on the result of treatment with ESWL. It was conducted in the urology department in Ibn Sina teaching hospital – Sirte – Libya in a four year period that extended from January 2010 to December 2013. Results: 129 patients with solitary renal stones were enrolled in the study, of whom 79 males (61%) and 50 females (39%). Patients' age ranged from 5 to 74 years old. Average stone size was 13.2 mm. There were 18 patients (14%) with stones in the upper calyx, 15 (12%) in the middle, 38 (29%) in the lower renal calyx and 58 (45) patients with stones in renal pelvis. Stone free rate was 72% in stones located in upper renal calyx, 80% in middle calyx, 53% in lower calyx and 81% in stones located in renal pelvis. Discussion: the finding of the current study is consistent with growing body of evidence that indicate that ESWL is least effective in case of stones located in the lower renal calyx. Therefore, early stone localization might help in the decision making and selection of the best option for the stones located in sites less responsive to ESWL. Conclusion: patients' selection and stone site localization are important points to help in decision making before ESWL since other treatment options should be considered in patients with lower renal calyceal stones, or any other patients who may not benefit from ESWL.

المراجع

(1) Moftakhar L, Jafari F, Ghoddusi Johari M, Rezaeianzadeh R, Hosseini SV, Rezaianzadeh A. Prevalence and risk factors of kidney stone disease in population aged 40-70 years old in Kharameh cohort study: a cross-sectional population-based study in southern Iran. BMC Urol. 2022;22(1):205.

(2) Allam AT, El-Dessouki AM, El-Shiekh RA, Abou-Hussein D, Mahmoud MA, Marcus WH, et al. A holistic guide to effective prevention and treatment for kidney stones: a systematic review exploring anti-urolithiasis approaches. Naunyn Schmiedebergs Arch Pharmacol. 2026;399(3):3235-84.

(3) Butt AU, Khurram M, Ahmed A, Hasan Z, Rehman A, Farooqi MA. Extracorporeal shock wave lithotripsy. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 2005;15(10):638-41.

(4) Chaussy C, Brendel W, Schmiedt E. Extracorporeally induced destruction of kidney stones by shock waves. Lancet. 1980;2(8207):1265-8.

(5) Chaussy C, Schmiedt E, Jocham D, Brendel W, Forssmann B, Walther V. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. The Journal of urology. 1982;127(3):417-20.

(6) Nielsen TK, Jensen JB. Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones. BMC Urol. 2017;17(1):59.

(7) Massoud AM, Abdelbary AM, Al-Dessoukey AA, Moussa AS, Zayed AS, Mahmmoud O. The success of extracorporeal shock-wave lithotripsy based on the stone-attenuation value from non-contrast computed tomography. Arab J Urol. 2014;12(2):155-61.

(8) Nirmal K P MKG, Sunil R, Aravind S Ganapath. Treatment Outcomes Of Extracorporeal Shock Wave Lithotripsy For Urinary Calculi. Global Journal For Research Analysis. 2020;9 (11):1-3.

(9) S. Azab. A O. Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy. African Journal of Urology. 2013;19 (1):13 - 7.

(10) Ather MH, Abid F, Akhtar S, Khawaja K. Stone clearance in lower pole nephrolithiasis after extra corporeal shock wave lithotripsy - the controversy continues. BMC Urol. 2003; 3:1.

(11) Oliveira B, Teixeira B, Magalhaes M, Vinagre N, Fraga A, Cavadas V. Extracorporeal shock wave lithotripsy: retrospective study on possible predictors of treatment success and revisiting the role of non-contrast-enhanced computer tomography in kidney and ureteral stone disease. Urolithiasis. 2024;52(1):65.

(12) Semins MJ, Matlaga BR. Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters. World J Nephrol. 2015;4(2):230-4.

(13) Soyupek S, Armagan A, Kosar A, Serel TA, Hoscan MB, Perk H, et al. Risk factors for the formation of a steinstrasse after shock wave lithotripsy. Urol Int. 2005;74(4):323-5.

(14) Aydamirov M, Karkin K, Gurlen G, Alma E, Altunkol A, Kaplan E, et al. Risk factors for steinstrasse formation after extracorporeal shock wave lithotripsy for renal pelvic stones. BMC Urol. 2026;26(1):29.

(15) Abdelhafez MF, Bedke J, Amend B, ElGanainy E, Aboulella H, Elakkad M, et al. Minimally invasive percutaneous nephrolitholapaxy (PCNL) as an effective and safe procedure for large renal stones. BJU Int. 2012;110(11 Pt C):E1022-6.

(16) Sanguedolce F, Liatsikos E, Verze P, Hruby S, Breda A, Beatty JD, et al. Use of flexible ureteroscopy in the clinical practice for the treatment of renal stones: results from a large European survey conducted by the EAU Young Academic Urologists-Working Party on Endourology and Urolithiasis. Urolithiasis. 2014;42(4):329-34.

(17) Franchini M, Mannucci PM. Advances in the treatment of von Willebrand disease. Expert Rev Hematol. 2023;16(2):101–110.