J Med Assoc Thai 2011; 94 (9):1077

Views: 1,828 | Downloads: 231 | Responses: 0

PDF XML Respond to this article Print Alert & updates Request permissions Email to a friend


Kidney Stones Recurrence and Regrowth after Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrolithotomy
Chongruksut W Mail, Lojanapiwat B , Tawichasri C , Paichitvichean S , Euathrongchit J , Choomsai Na Ayudhya V , Patumanond J

Objective: To estimate and compare the incidence rate of kidney stone recurrence and regrowth after ESWL with PCNL atone, two, and three years.
Material and Method: A retrospective cohort study was performed. The study recruited patients aged more than 18 years,diagnosed with kidney stones and treated by ESWL or PCNL between January 2006 and August 2010 at the urological unitof a university hospital located in the northern part of Thailand. Data were retrieved from medical records and analyzedusing exact probability test or student’s t-test. Poisson regression was used to compare the recurrence rate and the regrowthrate between ESWL and PCNL.
Results: During three years of follow-up, the overall stones recurrence and regrowth were 15.5% and 25.1% in ESWL groupand 12.6% and 16% in PCNL group, repectively. At one, two and three years after treatment, stones recurrence rate inthe ESWL group were 13.1, 7.5 and 7.3 per 1,000 patient-months while in the PCNL group were 11.3, 6.1 and 5.4 per1,000 patient-months. After ESWL stones regrowth rates were 29.1, 12.3 and 11.9 per 1,000 patient-months, whereas afterPCNL were 11.3, 6.9 and 6.9 per 1,000 patient-months, respectively. In comparison to PCNL, the relative recurrence rateafter ESWL presented as incidence rate ratio (IRR) were 1.1 (95% CI; 0.4-3.2, p = 0.762), 1.2 (95% CI; 0.6-2.6, p = 0.517)and 1.4 (95% CI; 0.8-2.5, p = 0.271) at 1, 2 and 3 years, respectively. For regrowth, the IRRs were 2.6 (95% CI; 1.1-6.5,p = 0.012), 1.8 (95% CI; 0.9-3.4, p = 0.048), and 1.7(95%CI; 1.1-2.9, p = 0.017) at 1, 2 and 3 years, respectively.
Conclusion: Patients after ESWL had a higher trend of recurrent rates and statistically significant higher regrowth rates, incomparison with those after PCNL.
Keywords: Recurrence, Kidney stones, Aftercare, Percutaneous, Lithotripsy

Download: PDF