Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Surgery

Supervisor

Razvi, Hassan

2nd Supervisor

Bjazevic, Jennifer M

Co-Supervisor

3rd Supervisor

Huynh, Melissa J

Abstract

Introduction

Shockwave lithotripsy (SWL) is a surgical procedure used in urolithiasis treatment. Several factors can influence its results. This study aims to evaluate “real-world” success rates and identify predictors of treatment success in patients undergoing SWL.

Methods

Adult patients undergoing SWL for urolithiasis at three institutions in Canada and Oman were prospectively enrolled. Treatment success after a maximum of two SWL sessions was assessed by post-operative imaging. Logistic regression assessed for predictors of treatment success.

Results

Between May 2021 and February 2022, 271 patients were prospectively enrolled. Overall success rate was 46.1% after one SWL session, and 58.3% after two sessions. In the univariable and multivariable analyses, smaller stone size and stone surface, and lower stone attenuation on Computerized Tomography were predictors of treatment success.

Conclusion

After two SWL sessions, overall success was 58.3%. Factors related to the stone appear to be the most important in predicting treatment success after SWL.

Summary for Lay Audience

Shockwave lithotripsy is a procedure first described in the 1980s for the treatment of stones located in the kidney or in the portion of the urinary tract that connects the kidneys to the bladder (ureters). It is performed with the use of a machine called a lithotripter that applies shockwaves to break the stones. Although it is a minimally invasive and safe procedure, there are factors related to the patient, stone characteristics, and to the procedure itself that influence the success of the treatment. In this study the goal was to include patients who were scheduled to undergo shockwave lithotripsy in three different centers in the world using the same lithotripter and analyze the results and the factors influencing the procedure success. Analyzing the patients’ imaging performed after the procedure, 58.3% of the patients were considered as having had a successful shockwave lithotripsy, after a maximum of two procedures. The factors related to the stone, such as a stone size, were found to influence whether or not the procedure would be successful. Although the rates of success in this study were lower than previously described, it was performed by analyzing real-world patients receiving shockwave lithotripsy with the same lithotripter in different centers around the world, and the results should encourage other centers to analyze and understand their own results.

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