체외충격파쇄석술 후 요석의 재발률과 이에 영향을 미치는 인자: 5년간 추적 관찰
Recurrence Rate and Risk Factors for Stone Recurrence after Successful Extracorporeal Shock Wave Lithotripsy: 5-year-follow-up Study
김성대, 양원재, 정재용,
소속 상세정보
김성대 ( Kim Sung-Dae )
인제대학교 의과대학 비뇨기과학교실
양원재 ( Yang Won-Jae )
인제대학교 의과대학 비뇨기과학교실
정재용 ( Chung Jae-Yong )
인제대학교 의과대학 비뇨기과학교실
KMID : 0358320070480010049
Abstract
Purpose: After treatment, urinary stones are known to have high recurrence rates. Therefore, the recurrence rates and risk factors for recurrence after successful extracorporeal shock wave lithotripsy(ESWL) were investigated to help in the decisions making for the treatment of patients with urinary stones.
Materials & Methods: Between January 1999 and December 2000, 415 patients(444 renal units), treated by ESWL due to urinary stones, were followed up for 5 years using either KUB or sonography. Treatment success was defined as complete passage of the stone or insignificant stone fragments, less than 3mm in diameter, remaining. The stone recurrence rates were calculated using the Kaplan-Meier method. The possible risk factors for recurrence, such as sex, age, familial history of urinary stones, abnormal metabolic finding, pyuria after ESWL, stone location, size and multiplicity, were analyzed.
Results: The overall number of recurrent stones was 82 in 444 renal units (18.5%). Using the Kaplan-Meier method, the recurrence rates were determined as 7.5, 17.8, 34.8, 39.8 and 45.8%, respectively, for each year upto 5 years. Among the many possible risk factors for a recurrence, the stone location(especially lower calyx) and multiplicity were found to be significant(p=0.042, p=0.009).
Conclusion: Since the long term recurrence rates of the urinary stones can be as high as 45.8%, patients should be informed of this fact prior to treatment with ESWL. Especially, those patients with multiple or lower calyx stones should be followed-up more carefully.(Korean J Urol 2007; 48:49-53)
키워드
Recurrence;Extracorporeal shock wave lithotripsy;Risk factor
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