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Predicting ESWL success by determination of Hounsfield unit on non-contrast CT is clinically irrelevant in children

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Abstract

The necessity of determining stone density by non-contrast computerized tomography (NCCT) before extracorporeal shock wave lithotripsy (ESWL) is a controversial topic due to the radiation exposure. We aimed to investigate whether stone density is helpful in predicting the success of ESWL in pediatric patients or not. In this retrospective study, database of a single center was used to identify 232 children aged between 2 and 16 years. Patients with abnormal renal anatomy, distal obstruction, a known cystine stone disease, a previous history of an intervention regarding stone, and an insufficient follow-up period (< 3 months) were excluded from the study. A total of 209 patients were included in the study (94 with NCCT, 115 without NCCT). Groups were compared in terms of stone size, stone location, and stone-free rate at 3 months after a single ESWL session. The mean age was 6.17 ± 3.27 years and 120 (57.4%) of the patients were male and 89 (42.6%) were female. Mean stone size was 11.7 mm in NCCT group and 12.3 mm in non-NCCT group (p 0.128). The complete stone clearance rate in NCCT and non-NCCT group at 3 months after ESWL was 57.4% (54/94) and 54.7% (63/115), respectively, and there was no statistically significant difference (p 0.316). In conclusion, unnecessary NCCT use should be avoided before ESWL considering the similar success rates after ESWL and the risk of exposure to radiation.

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Authors and Affiliations

  1. Department of Pediatric Urology, Ankara University School of Medicine, Cebeci Children’s Hospital, Ankara, Turkey

    Aykut Akinci, Tarkan Soygur & Berk Burgu

  2. Department of Urology, Cubuk State Hospital, Ankara, Turkey

    Cagri Akpinar

  3. Department of Urology, Ankara University School of Medicine, Ankara, Turkey

    Muammer Babayigit & Murat Can Karaburun

Authors
  1. Aykut Akinci
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  2. Cagri Akpinar
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  3. Muammer Babayigit
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  4. Murat Can Karaburun
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  5. Tarkan Soygur
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  6. Berk Burgu
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All authors have made substantial contributions to the material submitted for publication; all have read and approved the final manuscript.

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Correspondence to Aykut Akinci.

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All procedures performed were accordance with the 1964 Helsinki Declaration and approval was obtained from the local ethics committee (2021/184).

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Accepted and presented as a poster presentation at the 30th ESPU Congress—2019—Lyon, France.

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Akinci, A., Akpinar, C., Babayigit, M. et al. Predicting ESWL success by determination of Hounsfield unit on non-contrast CT is clinically irrelevant in children. Urolithiasis 50, 223–228 (2022). https://doi.org/10.1007/s00240-022-01306-5

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  • DOI: https://doi.org/10.1007/s00240-022-01306-5

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