Does Aging Affect the Efficiency of Extracorporeal Shock Wave Lithotripsy (ESWL) on Ureter Stones?
DOI:
https://doi.org/10.17140/UAOJ-2-114Keywords:
Age, Extracorporeal Shock Wave Lithotripsy (ESWL), Urolithiasis, Stone free rateAbstract
Objective
Current evidence concerning the effect of aging on the treatment outcome of extracorporeal shock wave lithotripsy (ESWL) is still conflicting. We performed a retrospective analysis to investigate the effect of age on the treatment outcome of ESWL for ureteric stones.
Materials and Methods
Our study was a pair-matched analysis comparing the three month stone free rate (SFR) after primary ESWL. Between March 1st, 2013 and December 31st, 2015, a total of 1204 patients received ESWL in our facility. We recruited 131 patients who were above or equal to 65 years old, 72 of whom met our inclusion criteria. These patients were stratified into Group A. To compare differences in treatment outcome between age groups, patients in Group A were matched 1:1 to patients aged less than 65 years by their stone size, stone location and gender. These matched patients were sorted into Group B. We compared the three-month SFR and the effect of co-morbidities on the three-month SFR between the two groups using the Pearson’s chi-square test and multivariate analysis.
Results
Seventy-two patients were included with a male-to-female ratio of 1:1 in each group. The average stone size was 6.74 mm (95% confidence interval, CI: 7.51-5.96) and 6.61 mm (95% CI: 7.25-5.96) in Group A and B, respectively (p=0.799). There were no differences in the three month SFR between Group A and B (63.9% vs. 66.7%, p=0.726). Univariate analysis suggested that stone location and diameter were related to SFR. However, multivariate analysis failed to show any statistically significant factors affecting SFR, including age.
Conclusion
In our study, age did not affect the three month SFR of ESWL. Therefore, ESWL could be an effective treatment modality for older patients. However, prospective studies with detailed data collection are required to validate these findings.
References
Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on Interventional treatment for Urolithiasis. Eur Urol.2015; 69(3): 475-82. doi: 10.1016/j.eururo.2015.07.041
Ackermann DK, Fuhrimann R, Pfluger D, Studer UE, Zingg EJ. Prognosis after extracorporeal shock wave lithotripsy of radiopaque renal calculi: a multivariate analysis. Eur Urol. 1994; 25(2):105-109. doi: 10.1159/000475261
Abdel-Khalek M, Sheir KZ, Mokhtar AA, Eraky I, Kenawy M, Bazeed M. Prediction of success rate after extracorporeal shock-wave lithotripsy of renal stones--a multivariate analysis model.Scand J Urol Nephrol. 2004; 38(2): 161-7. doi: 10.1080/00365590310022626
Ng CF, Wong A, Tolley D. Is extracorporeal shock wave Retrospective Study | Volume 2 | Number 1| Yeh S-D lithotripsy the preferred treatment option for elderly patients with urinary stone? A multivariate analysis of the effect of patient age on treatment outcome. BJU Int. 2007; 100(2): 392-395. doi: 10.1111/j.1464-410X.2007.06909.x
DelakasD,KaryotisI,DaskalopoulosG,LianosE,Mavromanolakis E. Independent predictors of failure of shockwave lithotripsy for ureteral stones employing a second generation lithotripter. J Endourol. 2003; 17: 201-5. doi: 10.1089/089277903765444302
Gomha MA, Sheir KZ, Showky S, Abdel-Khalek M, Mokhtar AA, Madbouly K. Can we improve the prediction of stone-free status after extracorporeal shock wave lithotripsy for ureteral stones? A neural network or a statistical model? J Urol. 2004; 172: 175-179. doi: 10.1097/01.ju.0000128646.20349.27
St-Onge MP, Gallagher D. Body composition changes with aging: the cause or the result of alterations in metabolic rate and macronutrient oxidation? Nutrition. 2010; 26(2): 152-5. doi: 10.1016/j.nut.2009.07.004
El-Nahas AR, El-Assmy AM, Mansour O, Sheir KZ. A prospective multivariate analysis of factors predicting stone disintegration by extracorporeal shock wave lithotripsy: the value of high-resolution noncontrast computed tomography. Eur Urol 2007; 51(6): 1688-1693; discussion 1693-1694. doi: 10.1016/j. eururo.2006.11.048
Philippou P, Lamrani D, Moraitis K, Bach C, Masood J, Buchholz N. Is shock wave lithotripsy efficient for the elderly stone formers? Results of a matched-pair analysis. Urol Res. 2011; 40(4): 299-304. doi: 10.1007/s00240-011-0424-4
Halachmi S, Meretyk S. Shock wave lithotripsy for ureteral stones in elderly male patients. Aging Male. 2006; 9(3): 171-174. doi: 10.1080/13685530600907985
Ikegaya H, Kato A, Kumano S, Tominaga T. Correlation between age and the efficacy of ESWL. BJU Int. 2005; 96(7): 1145. doi: 10.1111/j.1464-410X.2005.05924_2.x
Poletti PA, Platon A, Rutschmann OT, Schmidlin FR, Iselin CE, Becker CD. Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. AJR AmJ Roentgenol 2007; 188(4): 927-933. doi: 10.2214/AJR.06.0793
Huang W-Y, Chen Y-F, Carter S, Chang H-C, Lan C-F, Huang K-H. Epidemiology of upper urinary tract stone disease in a Taiwanese population: A nationwide, population based study. J Urol. 2013; 189(6): 2158-2163. doi: 10.1016/j.juro.2012.12.105 , et al 23
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