Stone Heterogeneity Index as a New Parameter for Prediction of Shockwave Lithotripsy Outcomes

Abstract

SWL was introduced more than three decades as an authentic modality for the treatment of urinary stone disease. It is considered as a first choice treatment for nearly all kind of urinary tract calculi. The outcome of ESWL for renal stones depends on many factors, including stone size, Hounsfield Unit and Skin to Stone Distance. The aim of this work was to introduce SHI as a single factor or in combination with other factors that predict the outcome of extracorporeal shock wave lithotripsy for adult patient with renal or ureteral stones. SHI may be affected by the compositional heterogeneity in urinary calculi as well as their structural and morphological heterogeneity. In summary, the radiologic heterogeneity of a urinary stone or SHI was independently associated with SWL success in patients with renal and ureteral calculi, thus SHI can be used as a useful clinical parameter for stone fragmentation. SHI will play a promising role when determining a treatment modality in patients with a urinary stone especially when selecting the proper SWL candidates from the patients with a stone of large size or high MSD.