Impact of advanced lithotripter technology on SWL success: ınsights from Modulith SLK ınline outcomes.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Erhan Erdoğan, Gamze Şimşek, Alper Aşık, Göksu Sarıca, Kemal Sarıca
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Abstract

Aim: This study aims to evaluate the success rate of Shock Wave Lithotripsy (SWL) in treating kidney stones using the Modulith SLK Inline lithotripter, with a focus on the importance of device efficacy as emphasized in EAU guidelines.

Patients and methods: This retrospective single-center study was conducted between June 2023 and June 2024. Inclusion criteria were adult patients (> 18 years) with radiologically confirmed renal stones smaller than 15 mm in diameter. Exclusion criteria included patients with solitary kidneys, significant renal functional deterioration, skeletal deformities, active urinary tract infections, pregnancy, or coagulopathies. Treatment outcomes were collected and analyzed in detail, considering patients' demographic characteristics (age, gender) and stone parameters (size, location, and hardness [Hounsfield Unit, HU]). The SWL procedures were performed using the Modulith SLK Inline lithotripter (Storz Medical, Switzerland). The success of SWL was defined as achieving complete stone clearance or the presence of clinically insignificant residual fragments (CIRF) (< 4 mm). This study seeks to provide detailed insights into the optimal use cases of SWL as a non-invasive yet effective treatment option for smaller, more manageable stones.

Results: The mean age of the 208 patients included in the study was 42.2 ± 12.7 years (18-75), with a male-to-female ratio of 1.9:1. The mean stone size across all patients was 10.3 mm, and the average HU value was 874.0 ± 283.2. Patients who achieved a completely stone-free status had significantly lower HU values (p = 0.049). The overall success rate of SWL was 78.8%, with 164 patients achieving complete stone clearance. When cases with clinically insignificant residual fragments (CIRF, < 4 mm) were included as successful outcomes, the overall success rate increased to 92.3%. This distinction highlights the inclusion of patients with small residual fragments that are deemed clinically irrelevant in the adjusted success rate. In cases with successful outcomes, the mean stone size was 10.3 mm, whereas it was 12.5 mm in patients with residual fragments or treatment failure. A statistically significant relationship was identified between stone size and treatment success rates (p < 0.001). In contrast, stone localization did not have a significant impact on SWL success rates (p = 0.377).

Conclusions: SWL has demonstrated its effectiveness in kidney stone treatment with a 78.8% complete stone-free rate using the Modulith SLK Inline lithotripter. Higher success rates were achieved with smaller stones (< 15 mm) and lower HU values. These findings support the significance of advanced lithotripter technology in establishing SWL as a valuable non-invasive option for stones under 15 mm.

先进碎石机技术对SWL成功的影响:ınsights来自Modulith SLK ınline结果。
目的:本研究旨在评估冲击波碎石术(SWL)在使用Modulith SLK内联碎石机治疗肾结石中的成功率,重点关注EAU指南中强调的器械疗效的重要性。患者和方法:该回顾性单中心研究于2023年6月至2024年6月进行。纳入标准为影像学证实肾结石直径小于15mm的成年患者(bb0 ~ 18岁)。排除标准包括孤立肾、明显肾功能恶化、骨骼畸形、活动性尿路感染、妊娠或凝血功能障碍患者。考虑患者的人口学特征(年龄、性别)和结石参数(大小、位置和硬度[Hounsfield Unit, HU]),收集并详细分析治疗结果。SWL程序使用Modulith SLK内联碎石机(瑞士Storz Medical)进行。SWL的成功定义为完全清除结石或存在临床不显著的残留碎片(CIRF)。结果:纳入研究的208例患者的平均年龄为42.2±12.7岁(18-75),男女比例为1.9:1。所有患者的平均结石大小为10.3 mm,平均HU值为874.0±283.2。达到完全无结石状态的患者HU值显著降低(p = 0.049)。SWL的总成功率为78.8%,164例患者完全清除结石。结论:使用Modulith SLK内置碎石机,SWL在肾结石治疗中显示出78.8%的完全无结石率。较小结石的成功率较高(
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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