The impact of Mayo Adhesion probability score on the success of extracorporeal shock wave lithotripsy for kidney stones.

Abstract

Urolithiasis is a prevalent condition in urology, with extracorporeal shock wave lithotripsy (ESWL) serving as a common treatment for kidney stones under 2 cm. The Mayo Adhesion Probability (MAP) score, calculated from perinephric fat characteristics, is traditionally used to assess surgical outcomes but has not been explored in the context of ESWL. This study aims to evaluate the effect of MAP score on the success rate of ESWL. This retrospective study included patients who underwent ESWL for kidney stones between January 2018 and June 2024 at a tertiary care center. Demographic data, stone characteristics, and MAP scores were obtained through CT imaging. ESWL success was defined as either complete stone clearance or a residual fragment less than 4 mm at three months post-procedure. Logistic regression and ROC analysis were employed to identify predictors of treatment success and to determine the optimal MAP score cutoff. A total of 260 patients were analyzed, divided into two groups: MAP score < 3 (n = 154) and MAP score ≥ 3 (n = 106). Patients with a MAP score ≥ 3 had a significantly lower ESWL success rate (49.1%) compared to those with a MAP score < 3 (71.4%; p = 0.001). Multivariate analysis identified MAP score, BMI, and stone size as significant predictors of ESWL success. ROC analysis established a MAP score cutoff of 2, with 76.5% sensitivity and 64.3% specificity. The MAP score is an independent predictor of ESWL success in kidney stone treatment. Preoperative MAP evaluation may improve patient selection and optimize ESWL outcomes.