Abstract:

Purpose: "Extracorporeal shock wave lithotripsy" (SWL) is the first step treatment option in kidney stones. But there are some disadvantages, such as the need for multiple sessions and anesthesia. In order to prevent this, studies that predict the success of SWL have increased in recent years. Method: Between December 2009 and May 2014, 34 children with SWL caused by kidney stone and computer tomography (BT) examination were evaluated. Patients were evaluated in two groups. In Group 1 the incidental kidney stone was detected and SWL was applied, and in Group 2 the failure of SWL, mini-perc was drawn in the BT was assessed. In BT, the diameter of the stone was measured by the value of hounsfield units (HU) and the skin-stone distance (SSD). The average HU values (HUave) are calculated. The data was compared according to the success of SWL. Successful SWL was considered to be completely stone-free. Results: In Group 1 SWL successful 8 patients, failure 4 patients in total 12 patients, in Group 2 SWL failure 22 patients were assessed. In Group 1, the average HUave values of successful and unsuccessful SWL groups were 601,7 and 996,9HU (p<0,05). In the ROC analysis of thirty-four patients, the HUave cut-off value was 750HU (AUC = 0,856). According to HUave 750, a statistical significant difference was found when compared SWL success (OR=7,06, p=0,013). Factors affecting the success of SWL were identified as HUmin, HUmax, HUave and stone diameter. There is no significant difference in the value of the SSD. Debate and result: As a result, diameter and HU values are the factors that predict the success of SWL in kidneys. In order to prevent unnecessary SWL treatments, SWL pre-IT assessment should be supported by prospective studies.

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