Double J Stent Reduces The Efficacy Of Extracorporeal Shock Wave Lithotripsy In The Treatment Of Lumbar Ureteral Stones
CENTRAL EUROPEAN JOURNAL OF UROLOGY(2013)
Abstract
Introduction. We evaluated the effect of the presence of a double J stent on the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of lumbar ureteral stones.Material and methods. Between January 2007 and February 2012, we performed a retrospective cohort study. Forty-four patients were treated by ESWL for lumbar ureteral stones and included into two groups for the analysis: group 1, non-stented (n = 27) and group 2, stented patients (n = 17). Treatment efficacy was evaluated by abdominal X-ray or CT-scan at 1 month. Stone-free patients and those with a residual stone = 4 mm were considered to be cured.Results. Mean stone size and density in groups 1 and 2 were 8.2mm/831HU, and 9.7 mm/986HU respectively. Both groups were comparable for age, BMI, stone size and density, number, and power of ESWL shots given. The success rates in groups 1 and 2 where 81.5% and 47.1%, respectively (p = 0.017). There was no difference between the groups for stones measuring 8 mm or less (p = 0.574). For stones > 8 mm, the success rates were respectively 76% and 22.2% for groups 1 and 2 (p = 0.030). Logistic regression analysis revealed a higher failure rate when a double J stent was associated with a stone > 8 mm (p = 0.033).Conclusions. The presence of a double J stent affects the efficacy of ESWL in the treatment of lumbar ureteral stones. This effect is significant for stones > 8 mm. Ureteroscopy should be considered as the first-line treatment in such patients.
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Key words
shock wave lithotripsy, double J stent, ureteral stone, lumbar
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