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Ureteral stenting can be a negative predictor for successful outcome following shock wave lithotripsy in patients with ureteral stones

Authors
 Dong Hyuk Kang  ;  Kang Su Cho  ;  Won Sik Ham  ;  Doo Yong Chung  ;  Jong Kyou Kwon  ;  Young Deuk Choi  ;  Joo Yong Lee 
Citation
 Investigative and Clinical Urology, Vol.57(6) : 408-416, 2016 
Journal Title
 Investigative and Clinical Urology 
ISSN
 2466-0493 
Issue Date
2016
Abstract
PURPOSE: To evaluate ureteral stenting as a negative predictive factor influencing ureteral stone clearance and to estimate the probability of one-session success in shock wave lithotripsy (SWL) patients with a ureteral stone. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1,651 patients who underwent their first SWL. Among these patients, 680 had a ureteral stone measuring 4-20 mm and were thus eligible for our study. The 57 patients who underwent ureteral stenting during SWL were identified. Maximal stone length (MSL), mean stone density (MSD), skin-to-stone distance (SSD), and stone heterogeneity index (SHI) were determined by pre-SWL noncontrast computed tomography. RESULTS: After propensity score matching, 399 patients were extracted from the total patient cohort. There were no significant differences between stenting and stentless groups after matching, except for a higher one-session success rate in the stentless group (78.6% vs. 49.1%, p=0.026). In multivariate analysis, shorter MSL, lower MSD, higher SHI, and absence of a stent were positive predictors for one-session success in patients who underwent SWL. Using cutoff values of MSL and MSD obtained from receiver operator curve analysis, in patients with a lower MSD (≤784 HU), the success rate was lower in those with a stent (61.1%) than in those without (83.5%) (p=0.001). However, in patients with a higher MSL (>10 mm), the success rate was lower in those with a stent (23.6%) than in those without (52.2%) (p=0.002). CONCLUSIONS: Ureteral stenting during SWL was a negative predictor of one-session success in patients with a ureteral stone.
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T201604943.pdf Download
DOI
10.4111/icu.2016.57.6.408
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Dong Hyuk(강동혁)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Chung, Doo Yong(정두용)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152699
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