Peter Alken

Yuan C, Jian Z, Jin X, Ma YC, Li H, Wang KJ.
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China.

Di Franco CA, Burrello M, Guzzardi F, Intagliata E, Oxenius I, Galvagno L, Cordaro C.
Department of Urology, S. Elia Emergency Hospital, Caltanissetta.

Popov SV, Orlov IN, Asfandiyarov FR, Skryabin ON, Suleymanov MM, Sytnik DA.
Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, GBUZ Public Hospital of Saint Luca, Saint Petersburg, Russia.
2Astrakhan State Medicine University, Astrakhan, Russia.

Abstract

Background: The aims of this study were to determine the predictive value of decision support analysis for the shock wave lithotripsy (SWL) success rate and to analyze the data obtained from patients who underwent SWL to assess the factors influencing the outcome by using machine learning methods.

Methods: We retrospectively reviewed the medical records of 358 patients who underwent SWL for urinary stone (kidney and upper-ureter stone) between 2015 and 2018 and evaluated the possible prognostic features, including patient population characteristics, urinary stone characteristics on a non-contrast, computed tomographic image. We performed 80% training set and 20% test set for the predictions of success and mainly used decision tree-based machine learning algorithms, such as random forest (RF), extreme gradient boosting trees (XGBoost), and light gradient boosting method (LightGBM).

Results: In machine learning analysis, the prediction accuracies for stone-free were 86.0, 87.5, and 87.9%, and those for one-session success were 78.0, 77.4, and 77.0% using RF, XGBoost, and LightGBM, respectively. In predictions for stone-free, LightGBM yielded the best accuracy and RF yielded the best one in those for one-session success among those methods. The sensitivity and specificity values for machine learning analytics are (0.74 to 0.78 and 0.92 to 0.93) for stone-free and (0.79 to 0.81 and 0.74 to 0.75) for one-session success, respectively. The area under curve (AUC) values for machine learning analytics are (0.84 to 0.85) for stone-free and (0.77 to 0.78) for one-session success and their 95% confidence intervals (CIs) are (0.730 to 0.933) and (0.673 to 0.866) in average of methods, respectively.

Conclusions: We applied a selected machine learning analysis to predict the result after treatment of SWL for urinary stone. About 88% accurate machine learning based predictive model was evaluated. The importance of machine learning algorithm can give matched insights to domain knowledge on effective and influential factors for SWL success outcomes.
BMC Urol. 2020 Jul 3;20(1):88. doi: 10.1186/s12894-020-00662-x. PMID: 32620102. FREE ARTICLE

Raheem OA, Natale C, Dick B, Reddy AG, Yousif A, Khera M, Baum N.
Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA.
Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA.
Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.

Peng L, Wen J, Zhong W, Zeng G.
Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangzhou Medical University, Guangzhou, China.
Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China. 

Palmieri A, Arcaniolo D, Palumbo F, Verze P, Liguori G, Mondaini N, Falcone M, Scroppo FI, Salonia A, Cai T.
Department of Urology, University Federico II, Naples, Italy.
Department of Urology, University Vanvitelli, Naples, Italy.
San Giacomo Hospital, Monopoli, Bari, Italy.
Department of Urology, University of Trieste, Trieste, Italy.
Urology Unit, Nuovo San Giovanni di Dio Hospital, Florence, Italy.
Department of Urology, University of Turin, Turin, Italy.
Urology Unit, Ospedale di Circolo di Varese, Varese, Italy.
Department of Urology, University Vita e Salute, San Raffaele, Milan, Italy.
Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.

Wang T, Xia Q, Chen X, Jin X.
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.

Manzoor H, Saikali SW.
Mayo Hospital Lahore
Clemenceau Medical Center

van Huijgevoort NCM, Veld JV, Fockens P, Besselink MG, Boermeester MA, Arvanitakis M, van Hooft JE.
Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.
Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.
Department of Gastroenterology and Hepatology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Kalatharan V, Jandoc R, Grewal G, Nash DM, Welk B, Sarma S, Pei Y, Garg AX.
Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.
ICES, London, ON, Canada.
Division of Nephrology, University Health Network and University of Toronto, ON, Canada.
Division of Nephrology, Department of Medicine, Western University, London, ON, Canada.

Golan R, Cooper KL, Shah O.
Department of Urology, Columbia University Medical Center-NewYork-Presbyterian New York, NY.

Türer ÖB, Soyer T, Parlak E, Özcan HN, Bilen CY, Tanyel FC. Turk J.
Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Departments of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Departments of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Departments of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Ang AJS, Sharma AA, Sharma A.
Yong Loo Lin School of Medicine, Singapore, Singapore.
Johns Hopkins University, Baltimore, USA.
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Larrazabal RJB, Chiu HHC, Sandoval MAS.
Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, National Capital Region, Philippines.
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, National Capital Region, Philippines.
Division of Endocrinology, Diabetes and Metabolism, Department of Physiology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, National Capital Region, Philippines.

Prosyannikov MY, Zolotuhin OV, Madykin YY, Konstantinova OV, Voytko DA, Anokhin NV, Sivkov AV.
Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation, Moscow, Russia.
Voronezh regional hospital 1, chief urologist of the Voronezh region, Voronezh, Russia.
VGMU of. N. N. Burdenko, Voronezh, Russia.

Gul A, Gul M.
Department of Urology, University of Health Science, Bursa Yuksek Ihtisas Training and Research Hospital, 16100, Bursa, Turkey.
Department of Urology, Aksaray University School of Medicine, 68100, Aksaray, Turkey.
Laboratory of Reproductive Biology, Section 5701, Copenhagen University Hospital Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark.

Friedlander DF, Brant A, McClure TD, Del Pizzo J, Nowels MA, Trinh QD, Sedrakyan A, Chughtai B.
Brigham and Women's Hospital, Division of Urological Surgery, Harvard Medical School, Boston, MA, USA.
Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.

Belmir H, Azghari A, Sedki N.J.
Department of Vascular Surgery, Mohammed VI University of Health Sciences, Casablanca, Morocco.
Department of Vascular Surgery, Mohammed V University, Rabat, Morocco.
Department of Vascular Surgery, Cheikh Zaid Hospital, Rabat, Morocco.

Sonmez G, Demir F, Keske M, Karadag MA, Demirtaş A.J.
Department of Urology, Erciyes University, Kayseri, Turkey.
Department of Urology, Kayseri City Hospital, Kayseri, Turkey.

Yang B, Veneziano D, Somani BK.
Royal Hampshire Hospital, Winchester, UK.
Department of Urology and Kidney Transplant, GOM, Reggio Calabria, Italy.
University Hospital Southampton NHS Trust, UK.

Liao B, Mou XX, Liu JB, Wu T, Cui S.Zhonghua Nan Ke Xue.
Department of Urology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China.

Kızılay F, Özdemir T, Turna B, Karaca N, Şimşir A, Alper I, Nazlı O.
Departments of Urology, Ege University Faculty of Medicine, İzmir, Turkey.
Departments of Anaesthesiology, Ege University Faculty of Medicine, İzmir, Turkey.

Abstract

Technological advances in minimally invasive treatment of stone disease and its integration with concomitant clinical practice are amongst the most important achievements in urology. Despite the wealth of information accumulated over the years and the richness of existing literature, the knowledge about the definition, treatment and outcomes of residual stone fragments after percutaneous nephrolithotomy (PNL) is still insufficient. Due to the high stone load a lot of patients with staghorn stones have residual fragments (RFs) after treatment with PNL, which depends on the size of tract, definition of stone free rate (SFR), timing of evaluation and the imaging used. No consensus exists on the imaging modality or their timing in the evaluation of possible RFs. The treatment of residual stones is apparently different depending on the facilities of the department and the preference of the surgeon, which includes active surveillance, shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) or a second look PNL.
Asian J Urol. 2020 Apr;7(2):116-121. doi: 10.1016/j.ajur.2019.12.013. Epub 2019 Dec 31. PMID: 32257804. FREE ARTICLE

Aditya I, Kwong JCC, Krakowsky Y, Grober ED.
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of Urology, Department of Surgery, Women's College Hospital & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Yoshioka T, Omae K, Kawada T, Inoue Y, Sugimoto M, Oeda T, Yamasaki T, Fujio K, Otsuki H, Uehara S, Araki M, Fukuhara.
Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.
Department of Healthcare Epidemiology, Kyoto University School of Public Health in the Graduate School of Medicine, Kyoto, Japan.
Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.
Department of Healthcare Epidemiology, Kyoto University School of Public Health in the Graduate School of Medicine, Kyoto, Japan.
Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University, Fukushima, Japan.
Department of Urology, Onomichi Municipal Hospital, Hiroshima, Japan.
Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Department of Urology, Abiko Toho Hospital, Chiba, Japan.
Department of Urology, Kawasaki Medical School General Medical Center, Okayama, Japan.
Department of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Abstract

Purpose: To identify the role of Doppler US (DUS) in the prediction of factors affecting stone-clearance post-SWL for ureteral stones in addition to its role in prediction of pretreatment stone impaction.

Methods: We prospectively included patients with ureteric stone for SWL between October 2018 and September 2019. Patient's demographics were collected. Using DUS, resistive index (RI), Δ RI, and ureteric jets were evaluated in both kidneys. Also, stone site, volume, density, skin to stone distance, degree of hydronephrosis, ureteral wall thickness (UWT) were evaluated by NCCT. Univariate and multivariate logistic regression analyses were performed to identify factors that contribute to treatment success. Correlation between ipsilateral RI with other radiological findings predicting stone impaction was done.

Results: A total of 93 patients were finally included (61 males and 32 females). The mean age was 31.4 ± 7.7 years. The success rate (absence of significant residuals post 1 month by NCCT) was 51.6%. In multivariate analysis, the presence of ureteric jet, ipsilateral lower RI, and ipsilateral lower UWT were independent factors for treatment success (P = 0.0001, 0.002, and 0.03, respectively). Also, ipsilateral absence of ureteric jet, increased hydronephrosis, and increased UWT were correlated with higher ipsilateral RI in prediction of stone impaction. Ipsilateral higher RI was found to achieve higher accuracy in stone impaction prediction (PPV of 94.8%).

Conclusion: Pretreatment DUS is a useful, non-invasive with a less irradiative tool for prediction of stone impaction and stone-free rate post-SWL for ureteric stones.

Minerva Urol Nefrol. 2020 Apr 16. doi: 10.23736/S0393-2249.20.03792-3. Online ahead of print. PMID: 32298068.

Jdaini A, Aynaou M, Irzi M, Mhanna T, El Farhaoui H, Barki A.
Department of Urology, Mohammed IV University Medical Center, Mohammed the First University Oujda, Morocco.

Dhawan S, Olweny EO.
Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA.

Lorio E, Patel P, Rosenkranz L, Patel S, Sayana H.
Department of Internal Medicine, UT Health San Antonio - Long School of Medicine, San Antonio, TX, 78229-3900, USA.
Division of Gastroenterology & Nutrition, Department of Medicine, UT Health San Antonio - Long School of Medicine, MC 7878, 7703 Floyd Curl Dr., San Antonio, TX, 78229-3900, USA.
Division of Gastroenterology & Nutrition, Department of Medicine, UT Health San Antonio - Long School of Medicine, MC 7878, 7703 Floyd Curl Dr., San Antonio, TX, 78229-3900, USA.

Hyun JJ, Irani SS, Ross AS, Larsen MC, Gluck M, Kozarek RA.
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA.

Huang Y, Chai S, Wang D, Li W, Zhang X.
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Nesheiwat Z, Sheikh T, Patel D, Burmeister C, Balla M.
Cardiology, University of Toledo Medical Center, Toledo, USA.
Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, USA.
Internal Medicine, University of Toledo Medical Center, Toledo, USA.
Internal Medicine, University of Toledo, Toledo, USA.
Internal Medicine, Promedical Toledo Hospital, Toledo, USA.

Nemirovsky C, López Furst MJ, Pryluka D, De Vedia L, Scapellato P, Colque A, Barcelona L, Desse J, Caradonti M, Varcasia D, Ipohorski G, Votta R, Zylberman M, Romani A, Valdez P, Amalfa F, Lucero C, Fernández Lausi A, Fernández Garces A, Rodríguez C, Chattas A, Farina J, Clara L, Nuccetelli Y; Grupo de trabajo del Consenso Argentino de Infección.
Sociedad Argentina de Infectología, Argentina.
Sociedad Argentina de Infectología, Argentina.
Sociedad Argentina de Urología, Argentina.
Federación Argentina de Urología, Argentina.
Federación Argentina de Sociedades de Ginecología y Obstetricia, Argentina.
Sociedad Argentina de Medicina, Argentina.
Sociedad Argentina de Bacteriología, Micología y Parasitología Clínica, Argentina.
Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos Malbrán, Buenos Aires, Argentina.

Wang Y, Chang X, Li J, Han Z.
Department of Urology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Ur Rehman MF, Adnan M, Hassan A 3rd, Humayun Akhtar F, Javed N, Ali F.
Urology, Bakhtawar Amin Medical and Dental College, Multan, PAK.
Urology, University of Lahore Teaching Hospital, Lahore, PAK.
Urology, Children Hospital and Institute of Child Health, Lahore, PAK.
Paediatric Urology, Children Hospital and Institute of Child Health, Lahore, PAK.
Internal Medicine, District Headquarter Hospital, Khanewal, PAK.

Hughes SF, Jones N, Thomas-Wright SJ, Banwell J, Moyes AJ, Shergill I.

North Wales Clinical Research Centre, Betsi Cadwaladr University Health Board (BCUHB) Wrexham Maelor Hospital, Wrexham, Wales, UK.
North Wales & North West Urological Research Centre, Betsi Cadwaladr University Health Board (BCUHB) Wrexham Maelor Hospital, Wrexham, Wales, UK.
Department of Biological Sciences, University of Chester, Chester, UK.
Department of Haematology, Countess of Chester Hospital, Chester, UK.
North Wales & North West Urological Research Centre, Betsi Cadwaladr University Health Board (BCUHB) Wrexham Maelor Hospital, Wrexham, Wales, UK.
Department of Blood Sciences, BCUHB Wrexham Maelor Hospital, Wrexham, Wales, UK.
School of Medical Sciences, Bangor University, Bangor, Wales, UK.
North Wales Clinical Research Centre, Betsi Cadwaladr University Health Board (BCUHB) Wrexham Maelor Hospital, Wrexham, Wales, UK.
The Alan de Bolla Department of Urology, BCUHB Wrexham Maelor Hospital, Wrexham, Wales, UK.

Porst H.
European Institute for Sexual Health (EISH), Hamburg, Germany.

Wang X, Zhang B, Zhu Y, Ge H.
Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Al Darrab R, Addar AM, Al Shohaib I, Ghazwani Y.
Division of Urology, King Abdullah International Medical Research Center, College of Medicine, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Li X, Li B, Meng Y, Yang L, Wu G, Jing H, Bi J, Zhang J.
Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.
Department of Urology, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Shenyang, 110001, Liaoning Province, People's Republic of China.
Department of Hepatobiliary Surgery, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.

Çift A, Benlioglu C.
Department of Urology, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey.
Department of Urology, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey.

Kaya C, Kaynak Y, Karabag A, Aykaç A.
Department of Urology, Eskisehir City Hospital, Eskisehir, Turkey.
Department of Urology, Eskisehir Ümit Visnelik Hospital, Eskisehir, Turkey.
Department of Radiology, Eskisehir City Hospital, Eskisehir, Turkey.
Department of Urology, Medical School, Karabuk University, Karabuk, Turkey.

Danilovic A.
Serviço de Urologia, Hospital das Clínicas da Faculdade de Medicina da USP - HCFMUSP, São Paulo, SP, Brasil.

Chen TT, Samson PC, Sorensen MD, Bailey MR.
Department of Urology, University of Washington, Seattle, Washington.
Department of Urology, Weill Cornell Medicine, New York, New York.
Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington, Seattle, Washington, USA.

Yayık AM, Ahıskalıoğlu A, Ergüney ÖD, Oral Ahıskalıoğlu E, Alıcı H, Demirdöğen ŞO, Adanur Ş.
Department of Anesthesiology and Reanimation, Ataturk University Faculty of Medicine, Erzurum, Turkey.
Department of Anesthesiology, Regional Training Hospital, Erzurum, Turkey.
Department of Urology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Asi T, Dogan HS, Altan M, Bozaci AC, Ceylan T, Asci A, Tekgul S.
Department of Urology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Department of Urology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

Musa ZS, El-Assmy A, Shokry AM, Shokeir AA, Zween T, Al-Kenawy MR.
Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Ramesh S, Chen TT, Maxwell AD, Cunitz BW, Dunmire B, Thiel J, Williams JC, Gardner A, Liu Z, Metzler I, Harper JD, Sorensen MD, Bailey MR.
Applied Physics Laboratory, Center for Industrial and Medical Ultrasound, University of Washington, Seattle, Washington.
Department of Urology, University of Washington School of Medicine, Seattle, Washington.
Department of Anatomy, Cell Biology and Physiology and Indiana University School of Medicine, Indianapolis, Indiana.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
Division of Urology, VA Puget Sound Health Care System, Seattle, Washington.

Stoykov B, Kolev N, Dunev V, Genov P.
Department of Urology, Medical University Pleven, Bulgaria.
Department of Urology, UMHAT, Ruse, Bulgaria.

Kallidonis P, Ntasiotis P, Somani B, Adamou C, Emiliani E, Knoll T, Skolarikos A, Tailly T.
Department of Urology, University of Patras, Patras, Greece.
European Section of Uro-Technology.
Young Academic Urologist.
Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Department of Urology, Fundacion Puigvert, University Autonoma of Barcelona, Barcelona, Spain.
Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany.
2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Urology, Ghent University Hospital, Ghent, Belgium.

Hegazy M, El-Assmy A, Ali-El-Dein B, Sheir KZ.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

El-Khoury HJ, Brookes JDL, Tan B, Shahbaz S, McCahy PJ.
Department of Urology, Casey Hospital, Monash Health, Melbourne, Victoria, Australia.
School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.

Abstract

Introduction: Lower pole kidney stones have been associated with poor shock wave lithotripsy (SWL) outcomes because of its location. However, the real impact of collecting system anatomy on stone clearance after SWL is uncertain. There is a lack of prospective well-controlled studies to determine whether lower pole kidney stones have inferior outcomes than nonlower pole kidney stones when treated with SWL. Methods: We prospectively evaluated patients with a single kidney stone of 5-15 mm undergoing SWL from June 12 through January 19. All patients were subjected to computed tomography before and 3 months after the procedure. Demographic data (age, gender, and body mass index), stone features (stone size, stone area, stone density, and stone-skin distance-SSD), and collecting system anatomy (infundibular length and width, and infundibulopelvic angle) were recorded. Outcomes (fragmentation and stone clearance rates) were compared between lower pole and nonlower pole cases. Then, a multivariate analysis including all variables was performed to determinate which parameters significantly impact on SWL outcomes. Results: One hundred and twenty patients were included in the study. Mean stone size was 8.3 mm and mean stone density was 805 Hounsfield units. Overall stone fragmentation, success, and stone-free rates were 84.1%, 64.1%, and 34.1%, respectively. There were no significant differences in stone fragmentation (76.0% vs 71.4%; p = 0.624), success rate (57.6% vs 53.3%; p = 0.435), and stone-free rate (40.2% vs 35.7%; p = 0.422) in the lower vs nonlower pole groups, respectively. On multivariate analysis, only stone density (p < 0.001) and SSD (p = 0.006) significantly influenced fragmentation. Stone size (p = 0.029), stone density (p = 0.002), and SSD (p = 0.049) significantly influenced kidney stone clearance. Conclusions: Stone size, stone density, and SSD impact on SWL outcomes. Lower pole kidney stones have similar fragmentation and stone clearance compared with nonlower pole kidney stones.
J Endourol. 2020 Jan;34(1):63-67. doi: 10.1089/end.2019.0545. Epub 2019 Nov 21.

Cui HW, Silva MD, Mills AW, North BV, Turney BW.
Oxford Stone Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
University of Lisbon, Faculty of Sciences, Lisbon, Portugal.
Exploristics Ltd., Belfast, United Kingdom.
Oxford Stone Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.

Han CS, Vetter JM, Endicott R, Chevinsky M, Zafar A, Venkatesh R.
Washington University School of Medicine, St. Louis, MO, USA.
Midwest Stone Institute, St. Louis, MO, USA.
Washington University School of Medicine, St. Louis, MO, USA.

Gulati G, Kiernan M, Sabe MA.
Cardiovascular Center, Tufts Medical Center, Boston, MA, United States.
Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

Yadav P, Madhavan K, Syal S, Farooq A, Srivastava A, Ansari MS.
Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, U.P., 226014, India.
Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, U.P., 226014, India.

Lee SM, Collin N, Wiseman H, Philip J.
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Department of Interventional Radiology, Southmead Hospital, Bristol, UK.

Sir E, Eksert S, Zor M, Emin Ince M, Kaya E, Bedir S.
Servicio de Anestesiología. Hospital de Investigación y Formación Gulhane. Ankara Turkey.
Servicio de Urología. Hospital de Investigación y Formación Gulhane. Ankara Turkey.

Hiller SC, Ghani KR.
Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

Kim KS, Jeong HC, Choi SW, Choi YS, Cho HJ, Ha US, Hong SH, Lee JY, Lee SW, Ahn ST, Moon DG, Bae WJ, Kim SW.
Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Kim KS, Jeong HC, Choi SW, Choi YS, Cho HJ, Ha US, Hong SH, Lee JY, Lee SW, Ahn ST, Moon DG, Bae WJ, Kim SW.
Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Liu Y, Hao L, Wang T, Li ZS, Xu ZL, Hu LH.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People's Hospital), Jinan University, 1017 North Dongmen Road, Shenzhen, Guangdong, China.
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.

Sramkova T, Motil I, Jarkovsky J, Sramkova K.
Department of Sexology, University Hospital and Department of Traumatology, Masaryk University, Brno, Czechia.
Department of Urology First Faculty of Medicine, Charles University Prague and General University Hospital, Prague, Czechia.
EURED Urology, Andrology Center, Brno, Czechia.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia.
Department of Urology, St. Anna Hospital, Brno, Czechia.

Dauw CA, Swarna K, Qi J, Kim T, Leavitt D, Leese J, Abdelhady M, Witzke K, Hollingsworth JM, Ghani KR.
University of Michigan, Ann Arbor, MI.
University of Michigan, Ann Arbor, MI.
Henry Ford Health System-Vattikuti Urology Institute, Detroit, MI.
IHA-Urology, Ypsilanti, MI.
Detroit Medical Center-Department of Urology, Detroit, MI.
MidMichigan-Division of Urology, Midland, MI.

Bowen DK, Song L, Faerber J, Kim J, Scales CD Jr, Tasian GE.
Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Duke Clinical Research Institute, Departments of Surgery (Urology) and Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Department of Surgery, Division of Urology; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Sohail N, Albodour A, Abdelrahman KM.
Alkhor Hospital, Hamad Medical Corporation, Doha, Qatar.

Jeong HC, Bae WJ, Zhu GQ, Jeon SH, Choi SW, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang SY, Kim SW.
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
KEMIMEDI, Seoul, Korea.

Donaldson JF, Ruhayel Y, Skolarikos A, MacLennan S, Yuan Y, Shepherd R, Thomas K, Seitz C, Petrik A, Türk C, Neisius A.
Department of Urology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Department of Urology, Skåne University Hospital, Malmö, Sweden.
Second Department of Urology, Sismanoglio Hospital, Athens Medical School, Athens, Greece.
Academic Urology Unit, University of Aberdeen, Scotland, UK.
Division of Gastroenterology & Cochrane UGPD Group, Department of Medicine, Health Sciences Centre, McMaster University, Hamilton, Canada.
European Association of Urology Guidelines Office, Arnhem, The Netherlands.
Department of Urology, Guy's Hospital, London, UK.
Department of Urology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria.
Department of Urology, Charles University, First Faculty of Medicine, Prague, Czech Republic.
Department of Urology, Hospital of the Sisters of Charity, Vienna, Austria; Urologische Praxis mit Steinzentrum, Vienna, Austria.
Department of Urology, Hospital of the Brothers of Mercy Trier, Johannes Gutenberg University Mainz, Trier, Germany.

Marchetti KA, Lee T, Raja N, Corona L, Kraft KH, Wan J, Ellison JS.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
University of Michigan Medical School, Ann Arbor, MI, USA.
Division of Pediatric Urology, Department of Urology, University of Michigan, Ann Arbor, MI, USA.
5Division of Pediatric Urology, Children's Hospital of Wisconsin & Medical College of Wisconsin, Milwaukee, WI, USA.

Jeon SH, Zhu GQ, Kwon EB, Lee KW, Cho HJ, Ha US, Hong SH, Lee JY, Bae WJ, Kim SW.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Republic of Korea.

Spivak L, Shultz T, Appel B, Verze P, Yagudaev D, Vinarov A.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Electronic address: .
Medispec Ltd., Gaithersburg, Maryland, USA.
Neuro-urology Unit, Rambam Healthcare Campus, Haifa, Israel.
Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Yamashita S, Kohjimoto Y, Iguchi T, Nishizawa S, Kikkawa K, Hara I.
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan.
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan.

Pietropaolo A, Reeves T, Aboumarzouk O, Kallidonis P, Ozsoy M, Skolarikos A, Tailly T, Liatsikos E, Traxer O, Somani BK.
Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.
Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Medical University of Vienna, Vienna, Austria.
2nd Department of Urology, University of Athens, Sismanoglio Hospital, Athens, Greece.
Department of Urology, University Hospitals Ghent, Ghent, Belgium.
Tenon Hospital, Pierre and Marie Curie University, Paris, France.

Yayik AM, Ahiskalioglu A, Alici HA, Celik EC, Cesur S, Ahiskalioglu EO, Demirdogen SO, Karaca O, Adanur S.
Department of Anesthesiology, Regional Training and Research Hospital, Erzurum, Turkey.
Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Urology, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Anesthesiology and Reanimation, Baskent University, Konya, Turkey.

Betschart P, Zumstein V, Jichlinski P, Herrmann TRW, Knoll T, Engeler DS, Müllhaupt G, Schmid HP, Abt D.
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Department of Urology, University Hospital of Lausanne, Lausanne, Switzerland.
Department of Urology, Cantonal Hospital Thurgau, Thurgau, Switzerland.
Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany.

El-Tatawy H, El-Abd AS, Gameel TA, Ramadan AR, Abo Farha MO, Sabaa MA, El-Abd SA.
Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.

Sultan S, Aba Umer S, Ahmed B, Naqvi SAA, Rizvi SAH.
Philip G. Ransley Department of Paediatric Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Zeng T, Tiselius HG, Huang J, Deng T, Zeng G, Wu W.
Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China.
Division of Urology, Department of Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.

Krieger JR, Rizk PJ, Kohn TP, Pastuszak A.
Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Urology, University of Miami, Miami, FL, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.

Elbaset MA, Hashem A, Eraky A, Badawy MA, El-Assmy A, Sheir KZ, Shokeir AA.
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Urology Department, Mediclin Muritz Hospital, Waren, Germany.
Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Dai JC, Bailey MR, Sorensen MD, Harper JD. Department of Urology, University of Washington School of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356510, Seattle. Center for Industrial and Medical Ultrasound, University of Washington, 1014 NorthEast 40th Street, Seattle, WA 98105, USA; Department of Mechanical Engineering, University of Washington, Stevens Way, Box 352600, Seattle, WA 98195, USA. Puget Sound Veterans Affairs Hospital, 1660 S. Columbian Way, Seattle, WA 98108, USA.

Alexander CE, Gowland S, Cadwallader J, Hopkins D, Reynard JM, Turney BW.
School of Medicine, University of St Andrews, St Andrews, United Kingdom.
Mobile Medical Technology, Christchurch, New Zealand.
Mobile Medical Technology, Auckland, New Zealand.
Oxford Stone Group, Department of Urology, Nuffield Department of Surgical Sciences, The Churchill Hospital, Oxford, United Kingdom.

Rayegani SM, Razzaghi MR, Raeissadat SA, Allameh F, Eliaspour D, Abedi AR, Javadi A, Rahavian AH.
Physical Medicine and Rehabilitation Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Laser Application in Medical Sciences Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Center of Excellence in Training Laser Application in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Physical Medicine and Rehabilitation Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Maxwell AD, Wang YN, Kreider W, Cunitz BW, Starr F, Lee D, Nazari Y, Williams JC Jr, Bailey MR, Sorensen MD. Department of Urology, University of Washington School of Medicine, Seattle, Washington. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington.
Department of Radiology, University of Washington School of Medicine, Seattle, Washington.
Department of Anatomy and Cell Biology, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana.
Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington.

Yuan P, Ma D, Zhang Y, Gao X, Liu Z, Li R, Wang T, Wang S, Liu J, Liu X.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Eryilmaz R, Kaplan Ş, Aslan R, Demir M, Taken K.
Department of Urology , Yuzuncu Yil University, School of Medicine , Van , Turkey. Department of Urology , Van Educational Research Hospital , Van , Turkey.

Talso M, Tefik T, Mantica G, Rodriguez Socarras M, Kartalas Goumas I, Somani BK, Esperto F.
Department of Urology, ASST Vimercate Hospital, Monza Brianza, Italy.
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy. Department of Urology, ASST Vimercate Hospital, Monza Brianza, Italy. Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK. Department of Urology, Humanitas Gavezzeni, Bergamo, Italy.

Chi-Fai N, Yee CH, Teoh JY, Lau B, Leung SC, Wong CY, Tak WK, Chu WC, Yuen J.
SH Ho Urology Center, Department of Surgery, The Chinese University of Hong Kong , Hong Kong.
Department of Imaging and Intervention Radiology, The Chinese University of Hong Kong , Hong Kong.
School of Nursing, Hong Kong Polytechnic University , Hong Kong.

Irer B, Sahin MO, Erbatu O, Yildiz A, Ongun S, Cinar O, Cihan A, Sahin M, Sen V, Ucer O, Kizilay F, Bozkurt O.
Departments of Urology, Izmir Metropolitan Municipality Esrefpasa Hospital, Izmir, Turkey, Manisa State Hospital, Manisa, Celal Bayar University School of Medicine, Manisa, Dokuz Eylul University School of Medicine, Izmir, Balikesir University School of Medicine, Balıkesir, Bulent Ecevit University School of Medicine, Zonguldak, Nigde Omer Halisdemir University School of Medicine, Nigde,Department of Urology, Ege University School of Medicine, Izmir, Manisa State Hospital, Manisa, Turkey.

Pricop C, Radavoi GD, Puia D, Vechiu C, Jinga V
Gr.T.Popa" University of Medicine and Pharmacy - Urology, Iasi, Romania.
"Dr. C.I. Parhon" Hospital - Department of Urology and Renal Transplantation, Iasi, Romania.
"Prof. Dr. Th. Burghele" Clinical Hospital - Urology, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Yazici O, Kafkasli A, Erbin A, Bilal Hamarat M, Cubuk A, Sarilar O, Sarica K.
Department of Urology, Haseki Training and Research Hospital, Estambul, Turquía. Department of Urology, Kucukyali Delta Hospital, Estambul, Turquía. Department of Urology, Konya Training and Research Hospital, Iconio, Turquía.

Nazarov TK, Komyakov BK, Rychkov IV, Trubnikova KE, Tursunov AI.
FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia.

Sugiyama M, Fujimura M, Nakamori H, Nishikawa R, Sakamoto S, Sekita N, Suzuki H, Mikami K, Ichikawa T.
Department of Urology, Chibaken Saiseikai Narashino Hospital
Department of Urology, Chiba University, 1-8-1, Inohana, Japan
Department of Urology, Funabashi Central Hospital, Japan.
Department of Urology, Toho University Medical Center Sakura Hospital, Japan.

Khanna A, Monga M, Sun D, Gao T, Schold J, Abouassaly R. Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH.
Quantitative Health Science, Cleveland Clinic, Cleveland, OH.

Özsoy M, Somani B, Seitz C, Veser J, Kallidonis P.
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital.
Urology and Andrology, Karl Landsteiner Society, Vienna, Austria.
University Hospital Southampton NHS Trust.
University of Southampton, Southampton, UK.
Department of Urology, University of Patras, Patras, Greece

Scotland K, Safaee Ardekani G, Chan J, Paterson R, Chew BH.

Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

Kaydu A, Gokcek E.
Department of Anesthesiology, Diyarbakir State Hospital, Diyarbakir, Turkey.