الفهرس 
Principles of ESWLOnly 14 pages are availabe for public view
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Abstract
Between November 2004 and February 2007, 100 patients with single renal stone were treated by ESWL in Urology and Nephrology Centre. Sixty two males and 38 females were included in this study with mean patient age 41.36±11.18 years and mean BMI 28.68±5.27. Those patients have single renal stone. All patients underwent full medical evaluation. Computed tomography was used to evaluate stone volume, volume of the containing stone site, and the ratio between them. Stone density was evaluated by estimation of hounsfield units of the stone. For lower pole stones, lower pole anatomical features of the treated kidney were measured and analyzed. These features were infundibular width, length and surface area, pelvicalyceal height and infundibulopelvic angle. The stones were located in 47 right and 53 left renal units. Sixty percent of the treated stones were found in renal pelvis while 7%, 8% and 25% of the treated stones were found in the upper calyx, middle calyx and lower calyx respectively. Mean volume of the stone was 1207±884.54mm3 while mean volume of the containing renal site was 3509.28±2400mm3 and the mean ratio in-between was 0.42±0.25. Mean housenfield unit through bone window was 745.1±208.5 and through tissue window was 660.15±192.89. Anatomical features of the lower pole anatomy showed that mean infundibular length was 19.72±6.44mm, mean infundibular width was 5.19±2.35mm, mean infundibular surface area was 69.54±57.9mm2 and mean infundibulopelvic angle was 51±20.55º. ESWL was performed as an out-patient procedure under sedation using the electromagnetic lithotripter (DoLi S, Dornier med Tech). A total of 3000 shock waves delivered for each session. After the session, patients were evaluated using X-ray and ultrasound to evaluate the results of the treatment and to identify the need for retreatment. The interval between sessions was not less than one week. All patients were followed up 4 weeks after the last session by computed tomography. Success rate of ESWL was 83% while free rate was 72%. Univariate analysis of the results showed that none of the studied factors showed significant impact on the results of ESWL. However, success rate was higher with some numerical factors like: smaller body mass index, smaller stone volume, shorter infundibular length, wider infundibular width, larger infundibular surface area and wider infundibulopelvic angle. Univariate analysis of categorical factors showed that none of these factors has a significant effect on the results of ESWL. In spite of this result, success rate and free rate were affected more with some factors. Success rate for renal pelvic stones was 86.7% while it was 85.7%, 62.5% and 80% for stone in upper calyx, middle calyx and lower calyx respectively. Radio opaque stone has success rate 84.3% while faint or radiolucent stone has success rate 72.7%. Normal morphological kidney showed success rate 83.9% while it was 71.4% for hydronephrotic kidneys. We concluded that ESWL is one of the successful methods of treatment of renal stones. There were no identifiable factors which affect results of ESWL significantly, but we identified some numerical and categorical factors which give better success and free rates with ESWL. To evaluate which of these factors has more significance, a new study was required with larger number of patients.