Extracorporeal shock wave lithotripsy with Piezolith 3000 plus in the management of single ureteral stone:An analysis of its safety, efficacy and failure factors
CHEN Weiying, CHEN Jiya, HAN Zihua, LI Feiping,YU Hongyuan.
Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou Enze Medical Center (Group), Affilitated to Hangzhou Medical College, Taizhou 318000, China
CHEN Weiying,CHEN Jiya,HAN Zihua, et al. Extracorporeal shock wave lithotripsy with Piezolith 3000 plus in the management of single ureteral stone:An analysis of its safety, efficacy and failure factors[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(1): 31-35.
Abstract：Objective: To investigate the safety, efficacy and failure factors of the latest generation Piezolith 3000 plus extracorporeal shock wave lithotripsy (SWL) in the treatment of single ureteral stone. Methods: A total of 3 515 patients underwent Piezolith 3000 plus SWL for single ureteral stone from February 2019 to July 2022.There were 2 167 males and 1 348 females with a mean age of (41.2±9.3) years (range, 10 months to 76 years),in which there were 9 children (0.25%) including 4 males and 5 females. The single stone was located in the upper ureter in 1 620 (46.1%), the mid-ureter in 489 (13.9%), and the lower ureter in 1 406 (40.0%). The diameter of stone was 0.7-2.0 (0.94±0.16) cm. The stone-free rate, auxiliary treatment rate, re-treatment rate and related complications were recorded and evaluated. Results: Of 3 515 patients, 2 897 (82.42%) were successfully treated with SWL at once, with the stone-free rate at 3mo being 91.04%, the re-treatment rate 8.62%, and the overall efficiency quotient (EQ) 81.7. Hematuria was the most common postoperative complication and no serious complications were found. In univariate analysis, calculous location, size, and grade of hydronephrosis between two groups showed significant differences (all P<0.05). The predictive factors of SWL failure were BMI>25 kg/m2 (OR=1.795, 95%CI=1.127-3.157), calculous size≥1.0 cm (OR=2.157, 95%CI=1.413-5.647), calculous location(upper ureter, OR=3.155, 95%CI=1.399-11.765; mid-ureter, OR=6.098, 95%CI=1.569-52.632) and severe grade of hydronephrosis (mild, OR=1.244, 95%CI=1.054-1.686; Moderate, OR=1.335, 95%CI=1.088-1.569). Conclusion: The double-layer Piezolith 3000 plus lithotripter is safe and effective in the treatment of single ureteral stone with the advantages of fine gravel particles, high overall stone-free rate and being relatively painless and non-invasive.BMI>25 kg/m2, calculous size≥1 cm, location and severe hydronephrosis are importment independnt predictors of SWL failure.
