Effect of skin to stone distance on non-contrast computed tomography and mean attenuation value on the performance of shock wave lithotripsy in kidney stone disease

Ahmadullah; Sunil Kumar Panjwani; Muhammad Imran Malik; Mahmood Ahmed Memon; Shahzad Ali; Mehran Khan Lashari

Abstract
Objective: To determine mean skin to stone distance (SSD) for successful disintegration of renal stones in patients undergoing shock wave lithotripsy (SWL) for the treatment of renal stone.
Methodology: This descriptive cross-sectional study was conducted at the department of Urology, Sindh Institute of Urology and Transplantation, Karachi. A total number of 91 patients having stone size >4 mm was included in the study. Mean SSD was measured using NCCT before treatment with SWL. Data analysis was carried out using SPSS version 20.0.
Results: Out of 91 patients, there were 59 (64.8%) male and 32 (35.2%) females. The mean age of patients was 45.75+10.03 years. Mean duration of kidney stone disease was 8.28+4.21 months. Mean size of kidney stone was 12.95+3.24 mm. Mean SSD was 70.72+6.01 mm. Complete stone disintegration occurred in 84 (92.3%) patients while it was unsuccessful in seven (7.7%) patients. Mean SSD in patients with complete stone disintegration was 69.52+4.45 mm and was 94.71+2.28 in patients with unsuccessful stone disintegration (p<0.001).
Conclusion: Mean SSD was 69.52+4.45 mm in patients with successful stone clearance. SSD was higher in overweight to obese patients as compared to the normal weight patients.

Key words: Shock wave lithotripsy, non-contrast computed tomography, skin to stone distance, renal stone.

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