Evidence map›Paper›PMID 41878052›Full record

ArticleMedicine and pharmacy reports2026

Factors influencing extracorporeal shockwave lithotripsy efficiency in the management of lower pole stones.

Dóra-Andrea Miheler, Tibor Reman, Raul Gherasim, Olivér Á Vida, Daniel Porav-Hodade, Orsolya Mártha

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Article in Medicine and pharmacy reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Dóra-Andrea MihelerDepartment of Obstetrics and Gynecology, Clinical County Emergency Hospital Mures, Targu Mures, Romania.
Tibor RemanDepartment of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
Raul GherasimDepartment of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
Olivér Á VidaDepartment of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
Daniel Porav-HodadeDepartment of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
Orsolya MárthaDepartment of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: The low efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of lower pole stones is well known; the parameters which influence this effect are still under debate: patient age, stone size, presence of double J stent, body mass index (BMI), and radiological parameters of the lower calyx, such as infundibulopelvic angle (IPA), infundibulum length (IL), and width (IW) of patients and the skin-stone size. Methods: We studied the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in the treatment of lower calyx stones. All patients were investigated by uro-CT or intravenous urography (IVU), or kidney, ureter, bladder (KUB) radiography to confirm the diagnosis. J stents were inserted before therapy in 64 (18.6%) renal units. Factors affecting success, stone-free rate and complications were analyzed. We measured the skin-stone distance (SSD) of the lower calyx on 39 uro-CT image data, and infundibulum length, width and infundibulopelvic angle on 31 intravenous urography (IVU). Results: Our retrospective study (between 2021 and 2024) included a total of 344 patients who underwent ESWL for lower calyceal stone (172 men, 172 women) with an average stone size 9.093±2.829 mm. 68.605% of patients became stone-free after the first ESWL session. The average skin stone distances measured in 0°, 45°, 90° angles were 96.5 ± 24.92 mm. Using the Chi-square test, we concluded that previously stented patients had a statistically lower stone-free rate (SFR) than those without a stent. (p=0.0078). The body mass index (BMI) of patients also influenced the SFR, as calculated with an Unpaired t-test and Welch correction (p = 0.002). We did not find any statistically significant differences between skin-stone sizes of patients with or without successful stone fragmentation (p=0.1147), and infundibulum length (p=0.07), infundibulum width (p=0.7681), and infundibulopelvic angle (p=0.996). Conclusions: Single ESWL sessions often fail to achieve stone fragmentation and elimination, as this study shows. The success of ESWL sessions can be affected by the anatomical position of the stone, a lower pole kidney stone, the presence of pre-procedural double J stenting, and obesity.

Indexed as

double J stentextracorporeal shockwave lithotripsylower pole stoneurolithiasis

Identifiers

PMID41878052
PMCPMC13008026

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