PROGNOSIS AFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY OF RADIOPAQUE RENAL CALCULI - A MULTIVARIATE-ANALYSIS

To obtain a better understanding of the prognostic factors influencing treatment outcome after extracorporeal shock wave lithotripsy (ESWL), a multivariate logistic analysis of the data from 246 patients has be en undertaken. All of the patients were treated with the Dornier litho triptor HM-3 for radiopaque renal calculi. Treatment success was defin ed as stone-free within 3 months of one ESWL session and without adjuv ant measures after ESWL. In a first analysis, 210 patients with solita ry and multiple calculi without adjuvant measures before ESWL were stu died. Of 210 patients, 141 (67%) were free from stones after 3 months. Significant influences on the success rate were body mass index and s tone number. In a second analysis only those 160 patients with solitar y calculi were considered. In this group, age, body mass index, stone location, stone burden and serum calcium significantly influenced the prognosis. When patients with adjuvant measures were added to the anal ysis an increasing prognostic importance of the stone burden was seen. In patients with a small to medium stone burden (<4.0 cm(3)), the num ber of stones seemed to be more important than the stone burden. Patie nts appear to have the best chance for successful ESWL when their body mass index is between 20 and 28, their age is between 40 and 60 years , their stones are in the renal pelvis and solitary, the stone burden is <1.0 cm(3), and when their serum calcium is normal.