Role of Non-contrast Computed Tomography - Kidney, Ureter, and Bladder in Predicting the Stone Fragility and Extracorporeal Shock Wave Lithotripsy Success Rate
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 5
Abstract
Introduction: Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the treatment strategy of urolithiasis worldwide and continues to be a major therapeutic modality for treating a majority of upper urinary tract stones. Aim: The aim is to study the density of renal stone by non-contrast computed tomography (NCCT) scan as measured in Hounsfield unit (HU) and its correlation with susceptibility of fragmentation by ESWL. Materials and Methods: This is a prospective study conducted in 100 patients of renal stone disease who underwent ESWL treatment at Tirunelveli Medical College Hospital, during January 2016 to March 2107 were included in the study. Results: The overall success rate of ESWL was 80% in our study. 68/100 patients with <750 HU had 100% stone fragmentation and clearance. 12/100 patients with 750-100 HU had 59% stone fragmentation and clearance in the II sitting and 41% had stone fragmentation and clearance in III sitting (retreatment with ESWL needed). 20/100 patients with HU >1000 had significant residual fragment even after III sitting ESWL (auxiliary procedures needed) (there was a statistically significant difference with P < 0.001). Conclusion: For stones with HU >1000, other modalities of treatment (endoscopic and open stone surgery) are preferable to ESWL. NCCT estimation of stone density by HU predicts the successful outcome of the ESWL therapy.
Authors and Affiliations
S M Kannan, S Mangaiyarkarasi, S K Subhakanesh, A Larif, B Thiruvasagamani, Heber Anandan
Keywords
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