The effectiveness of extracorporal shock wave lithotripsy of urinary stones with different chemical composition

Grabskiy A.M.

Introduction. Detection of the dependence of the extracorporeal shockwave lithotripsy (ESWL) effectiveness on urinary stone composition is the goal of this study.

Materials and methods. In the Izmirlian MC, during the period from 2005 to 2013 one hundred thirty-eight patients’ stone fragments with urolithiasis have been studied aer the ESWL.

Results. The results of the stone fragment analysis revealed calcium oxalate monohydrate (vevellite) in 82.6% of patients, calcium oxalate dihydrate (weddellite) in 39.1% of patients, and carbonate – apatite, uric acid and struvite stones in 34.8%, 21.7% and 17.4% of patients accordingly. Correlation analysis revealed statistically significant dependence of that the number of shock waves on the concentration of calcium oxalate in the stone (p<0.05). While the higher concentration of carbonate, uric acid and struvite resulted in lower number of shock waves to fully fragment stones (r = 0.71, p<0.05).

Conclusion. The chemical composition of the stones does affect the effectiveness and results of the ESWL. Stone type early identification by examination of the first fragments, passed immediately after the ESWL session, will allow for timely introduction of drug treatment, thus increasing the efficacy of this treatment modality.

Author declares lack of the possible conflicts of interests.

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urolithiasis, extracorporeal shock wave lithotripsy, urinary stone composition