Does Aging Affect the Efficiency of Extracorporeal Shock Wave Lithotripsy (ESWL) on Ureter Stones?

Abstract

Objective Current evidence concerning the effect of aging on the treatment outcome of extracorporeal shock wave lithotripsy (ESWL) is still conflicting. We performed a retrospective analysis to investigate the effect of age on the treatment outcome of ESWL for ureteric stones. Materials and Methods Our study was a pair-matched analysis comparing the three month stone free rate (SFR) after primary ESWL. Between March 1st, 2013 and December 31st, 2015, a total of 1204 patients received ESWL in our facility. We recruited 131 patients who were above or equal to 65 years old, 72 of whom met our inclusion criteria. These patients were stratified into Group A. To compare differences in treatment outcome between age groups, patients in Group A were matched 1:1 to patients aged less than 65 years by their stone size, stone location and gender. These matched patients were sorted into Group B. We compared the three-month SFR and the effect of co-morbidities on the three-month SFR between the two groups using the Pearson’s chi-square test and multivariate analysis. Results Seventy-two patients were included with a male-to-female ratio of 1:1 in each group. The average stone size was 6.74 mm (95% confidence interval, CI: 7.51-5.96) and 6.61 mm (95% CI: 7.25-5.96) in Group A and B, respectively (p=0.799). There were no differences in the three month SFR between Group A and B (63.9% vs. 66.7%, p=0.726). Univariate analysis suggested that stone location and diameter were related to SFR. However, multivariate analysis failed to show any statistically significant factors affecting SFR, including age. Conclusion In our study, age did not affect the three month SFR of ESWL. Therefore, ESWL could be an effective treatment modality for older patients. However, prospective studies with detailed data collection are required to validate these findings.