An observational study on the predictability of the Triple-D score in the success rate of extracorporeal shock wave lithotripsy in renal stones 1 – 2 cm in diameter

Triple D score predicts SFR after ESWL successfully

  • Soumish Sengupta MCh(Urology/Genitourinary Surgery)
  • Supriya Basu MS MCH
  • Kadambari Ghosh PG Diploma
  • Subhrajyoti Sengupta MBBS
Keywords: Computed tomography, Efficacy, Extracorporeal shock, lithotripsy, Hounsfield unit, Predictability, Score, Stone free status

Abstract

Introduction: Evaluation of Triple-D scoring system to assess the stone free rate in individuals who were given extracorporeal shock wave lithotripsy (ESWL) for renal stones measuring 10-20 mm in diameter. Materials and methods: The study subjects were 120 patients who presented to the urological outpatient department with complaints of renal stones. Systemic Random Sampling technique was applied to select study subjects for study population with a Sampling Interval of 2. Prior to ESWL, Triple-D scoring comprising of three CT based metrics - stone dimension (volume), stone density (HU) and skin-to-stone distance (SSD) was done prior to ESWL as described by Tran et al. The score ranged from 0 (worst) to 3 (best). Treatment efficacy was studied by plain abdominal radiography three weeks after ESWL. Complete clearance was considered the “stone free status”. Results: In the study population, stone dimension, stone density and stone location were positive predictors of stone free rate after ESWL whereas age, sex and BMI of the patients, laterality of the stone and skin to stone distance were not. The area under the curve (AUC) of Triple-D scoring system was 0.598.Conclusion: Triple-D scoring system has been successfully validated as the SFR showed a parallel increase with every positive component.

 

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Author Biographies

Supriya Basu, MS MCH

Professor and Head of the Department of Urology, RG Kar Medical College and Hospital, Kolkata, West Bengal

Kadambari Ghosh, PG Diploma

Department of Radiodiagnosis, North Bengal Medical College and Hoapital, Sushrutanagar, West Bengal

Subhrajyoti Sengupta, MBBS

Department of Surgery, RG Kar Medical College and Hospital, Kolkata, West Bengal

References

Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. EurUrol 69(3):475–482

Assimos D, Krambeck A, Miller NL et al (2016) Surgical management of stones: American Urological Association/Endourological Society guideline, PART II. J Urol 196(4):1161–1169

Kanao K, Nakashima J, Nakagawa K et al (2006) Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy. J Urol 176(4 Pt 1):1453–1456

Leavitt D, de la Rosette J, Hoenig D (2016) Strategies for nonmedical management of upper urinary tract calculi. In: Wein A, Kavoussi L, Partin A, Peters C (eds) Campbell-Walsh’s urology. Elsevier, Philadelphia, pp 1235–1259

Dretler SP (1988) Stone fragility—a new therapeutic distinction. J Urol 139(5):1124–1127

Ringdén I, Tiselius HG (2007) Composition and clinically determined hardness of urinary tract stones. Scand J UrolNephrol 41(4):316–323

Pareek G, Armenakas NA, Fracchia JA (2003) Hounsfield units on computerized tomography predict stone-free rates after extracorporeal shock wave lithotripsy. J Urol 169(5):1679–1681

Pareek G, Hedican SP, Lee FT Jr, Nakada SY (2005) Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology 66(5):941–944

Ng CF, Siu DY, Wong A, Goggins W, Chan ES, Wong KT (2009) Development of a scoring system from noncontrast computerized tomography measurements to improve the selection of upper ureteral stone for extracorporeal shock wave lithotripsy. J Urol 181(3):1151–1157

Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA (2005) Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 65(1):33–36

Tran TY, McGillen K, Cone EB, Pareek G (2015) Triple D Score is a reportable predictor of shockwave lithotripsy stone-free rates. J Endourol 29(2):226–230

Gokce MI, Esen B, Gulpinar B, Suer E, Gulpinar O (2016) External validation of Triple D Score in an elderly (>/=65 years) population for prediction of success following shockwave lithotripsy. J Endourol 30(9):1009–1016

Ozgor F, Tosun M, Kayali Y, Savun M, Binbay M, Tepeler A (2017) External validation and evaluation of reliability and validity of the Triple D Score to predict stone-free status after extracorporeal shockwave lithotripsy. J Endourol 31(2):169–173

Ichiyanagi O, Fukuhara H, Kurokawa M, et al. Reinforcement of the Triple D score with simple addition of the intrarenal location for the prediction of the stone-free rate after shockwave lithotripsy for renal stones 10-20 mm in diameter. IntUrolNephrol. 2019;51(2):239-245.

Wiesenthal JD, Ghiculete D, Ray AA, Honey RJ, Pace KT (2011) A clinical nomogram to predict the successful shock wave lithotripsy of renal and ureteral calculi. J Urol 186(2):556–562

El-Nahas AR, El-Assmy AM, Mansour O, Sheir KZ (2007) A prospective multivariate analysis of factors predicting stone disintegration by extracorporeal shock wave lithotripsy: the value of high-resolution noncontrast computed tomography. EurUrol 51(6):1688–1693

Perks AE, Schuler TD, Lee J et al (2008) Stone attenuation and skin-to-stone distance on computed tomography predicts for stone fragmentation by shock wave lithotripsy. Urology 72(4):765–769

Abdel-Khalek M, Sheir KZ, Mokhtar AA, Eraky I, Kenawy M, Bazeed M (2004) Prediction of success rate after extracorporeal shock-wave lithotripsy of renal stones—a multivariate analysis model. Scand J UrolNephrol 38(2):161–167

Ichiyanagi O, Nagaoka A, Izumi T, Kawamura Y, Kato T (2015) Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy. Urolithiasis 43(5):419–426

Halachmi S, Meretyk S (2006) Shock wave lithotripsy for ureteral stones in elderly male patients. Aging Male 9(3):171–174

Abdel-Khalek M, Sheir K, Elsobky E, Showkey S, Kenawy M (2003) Prognostic factors for extracorporeal shock-wave lithotripsy of ureteric stones—a multivariate analysis study. Scand J UrolNephrol 37(5):413–418

Ikegaya H, Kato A, Kumano S, Tominaga T (2005) Correlation between age and the efficacy of ESWL. BJU Int 96(7):1145

Vakalopoulos I (2009) Development of a mathematical model to predict extracorporeal shockwave lithotripsy outcome. J Endourol 23(6):891–897

Kim JK, Ha SB, Jeon CH et al (2016) Clinical nomograms to predict stone-free rates after shock-wave lithotripsy: development and internal-validation. PLoS ONE 11(2):e0149333

CITATION
DOI: 10.26838/MEDRECH.2021.8.1.478
Published: 2021-02-28
How to Cite
1.
Sengupta S, Basu S, Ghosh K, Sengupta S. An observational study on the predictability of the Triple-D score in the success rate of extracorporeal shock wave lithotripsy in renal stones 1 – 2 cm in diameter: Triple D score predicts SFR after ESWL successfully. Med. res. chronicles [Internet]. 2021Feb.28 [cited 2024Dec.21];8(1):55-3. Available from: https://medrech.com/index.php/medrech/article/view/478
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Original Research Article