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Published in: Urolithiasis 2/2022

01-04-2022 | Original Paper

Predicting ESWL success by determination of Hounsfield unit on non-contrast CT is clinically irrelevant in children

Authors: Aykut Akinci, Cagri Akpinar, Muammer Babayigit, Murat Can Karaburun, Tarkan Soygur, Berk Burgu

Published in: Urolithiasis | Issue 2/2022

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Abstract

The necessity of determining stone density by non-contrast computerized tomography (NCCT) before extracorporeal shock wave lithotripsy (ESWL) is a controversial topic due to the radiation exposure. We aimed to investigate whether stone density is helpful in predicting the success of ESWL in pediatric patients or not. In this retrospective study, database of a single center was used to identify 232 children aged between 2 and 16 years. Patients with abnormal renal anatomy, distal obstruction, a known cystine stone disease, a previous history of an intervention regarding stone, and an insufficient follow-up period (< 3 months) were excluded from the study. A total of 209 patients were included in the study (94 with NCCT, 115 without NCCT). Groups were compared in terms of stone size, stone location, and stone-free rate at 3 months after a single ESWL session. The mean age was 6.17 ± 3.27 years and 120 (57.4%) of the patients were male and 89 (42.6%) were female. Mean stone size was 11.7 mm in NCCT group and 12.3 mm in non-NCCT group (p 0.128). The complete stone clearance rate in NCCT and non-NCCT group at 3 months after ESWL was 57.4% (54/94) and 54.7% (63/115), respectively, and there was no statistically significant difference (p 0.316). In conclusion, unnecessary NCCT use should be avoided before ESWL considering the similar success rates after ESWL and the risk of exposure to radiation.
Literature
1.
go back to reference Coe FL et al (1996) Kidney stones: medical and surgical management. Br J Urol 78(3):482 Coe FL et al (1996) Kidney stones: medical and surgical management. Br J Urol 78(3):482
2.
go back to reference Assimos D et al (2016) Surgical management of stones: American Urological Association/Endourological Society Guideline, PART I. J Urol 196(4):1153–1160CrossRef Assimos D et al (2016) Surgical management of stones: American Urological Association/Endourological Society Guideline, PART I. J Urol 196(4):1153–1160CrossRef
3.
go back to reference Gofrit ON et al (2001) Is the pediatric ureter as efficient as the adult ureter in transporting fragments following extracorporeal shock wave lithotripsy for renal calculi larger than 10 mm? J Urol 166(5):1862–1864CrossRef Gofrit ON et al (2001) Is the pediatric ureter as efficient as the adult ureter in transporting fragments following extracorporeal shock wave lithotripsy for renal calculi larger than 10 mm? J Urol 166(5):1862–1864CrossRef
11.
go back to reference Rembold CM (1998) Number needed to screen: development of a statistic for disease screening. BMJ 317(7154):307–312CrossRef Rembold CM (1998) Number needed to screen: development of a statistic for disease screening. BMJ 317(7154):307–312CrossRef
15.
go back to reference Morrison JC et al (2018) Ultrasound guided ureteroscopy in children: Safety and success. J Pediatr Urol 14(1):64.e61-64.e66CrossRef Morrison JC et al (2018) Ultrasound guided ureteroscopy in children: Safety and success. J Pediatr Urol 14(1):64.e61-64.e66CrossRef
16.
go back to reference Passerotti C et al (2009) Ultrasound versus computerized tomography for evaluating urolithiasis. J Urol 182(4S):1829–1834CrossRef Passerotti C et al (2009) Ultrasound versus computerized tomography for evaluating urolithiasis. J Urol 182(4S):1829–1834CrossRef
19.
26.
go back to reference Miah T, Kamat D (2017) Pediatric nephrolithiasis: a review. Pediatr Ann 46(6):e242–e244CrossRef Miah T, Kamat D (2017) Pediatric nephrolithiasis: a review. Pediatr Ann 46(6):e242–e244CrossRef
27.
go back to reference Kirejczyk JK et al (2014) An association between kidney stone composition and urinary metabolic disturbances in children. J Pediatr Urol 10(1):130–135CrossRef Kirejczyk JK et al (2014) An association between kidney stone composition and urinary metabolic disturbances in children. J Pediatr Urol 10(1):130–135CrossRef
28.
go back to reference Altan M et al (2017) Predicting the stone composition of children preoperatively by Hounsfield unit detection on non-contrast computed tomography. J Pediatr Urol 13(5):505.e501-505.e506CrossRef Altan M et al (2017) Predicting the stone composition of children preoperatively by Hounsfield unit detection on non-contrast computed tomography. J Pediatr Urol 13(5):505.e501-505.e506CrossRef
Metadata
Title
Predicting ESWL success by determination of Hounsfield unit on non-contrast CT is clinically irrelevant in children
Authors
Aykut Akinci
Cagri Akpinar
Muammer Babayigit
Murat Can Karaburun
Tarkan Soygur
Berk Burgu
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 2/2022
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-022-01306-5

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