Factors Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy in Stones of the Upper Urinary Tract

Introduction: Urinary tract stone disease is a prevalent condition, and there are numerous treatment options available. ESWL is a safe, effective method to treat urinary lithiasis. ESWL is usually an outpatient procedure. The success rate in ESWL depends on stone location, size, number, and fragility as well as calyceal anatomy and patency of the urinary tract. ESWL as a modality was recommended for stones less than 2 cm in size. Based on this aim of our study is to investigate the effectiveness of ESWL in treating upper urinary tract stones under 2 cm in size and also to investigate the variables affecting ESWL in upper urinary tract stone treatment outcomes. Methodology: We did this study as Single centre, Cross sectional study. Patients with upper urinary tract stones in the Department Of Urology, Tirunelveli Medical College Hospital, and Tirunelveli for period of 24 months, and our study included as many patients during the study period (100 patients). Patients of age group above 18 years irrespective of sex and patients with upper urinary tract stones less than 2 cm in size were included. Patients less than 18 years of age irrespective of sex, Non consenting patients, Upper urinary tract stones > 2cms ,pregnant women , with bleeding diathesis and with distal obstruction were excluded. Results: In our study population in 74 patient’s treatment with ESWL was success and in rest, 26 were failure, in our study, most commonly age range was from 30-35 years, with no impact on outcome. In our study population, 56 patients were male and rest 44 patients were female. Mean BMI was more in patients who had failure in outcome. Same with stone size and Hounsfield units. Higher the values of stone size, skin to stone distance, Hounsfield units poorer the outcome. Hydronephrosis was present in three patients. Number of sitting was once in 62 patients and twice in 38 patients. Conclusion: From our study, we concluded that predictive factors taken separately couldn’t identify all patients who are likely to benefit from ESWL and exclude those that will have an unfavourable outcome. A modern approach should be used combining various factors, including stone location, size, skin-stone distance, BMI, and stone density.