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Research Article

Effect of Stone Density, Skin-Stone Distance and Stone Size on Extracorporeal Shock Wave Lithotripsy Success of Ureter Stones: A Clinical Investigation


 

1 Department of Urology, Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
2 Department of Medical Biochemistry, Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
3 Department of Medical Biotechnology, Hacettepe University, Ankara, Türkiye
4 Department of Medical Biochemistry, Birecik State Hospital, Sanlıurfa, Türkiye
5 Department of Urology, Biruni University, Medical School, Istanbul, Türkiye


DOI : 10.33719/nju1560480
New J Urol. 2025;20(1):1-12.

Abstract

Objective: This study aimed to evaluate the impact of obesity on the outcomes of supine
percutaneous nephrolithotomy (PCNL) at a tertiary university hospital. Understanding surgical
outcomes in obese patients, given their rising prevalence and urolithiasis risk, is crucial for
optimizing treatment strategies.

Material and Methods: This retrospective study included data from 256 patients aged 18 and
older who underwent PCNL in the Galdakao-Valdivia position between July 2021 and July 2024
at a tertiary care hospital. Patients were divided into three groups according to their body mass
index (BMI): normal weight (BMI: 18-24.9 kg/m²), overweight (BMI: 25-29.9 kg/m²), and obese
(BMI: 30-34.9 kg/m²). Demographic data, stone characteristics, operative time, fluoroscopy
time, hospital stay, nephrostomy duration, stone free rates (SFR), and complications were
analyzed and compared among the groups.

Results: No significant difference was found among the groups regarding age, sex, stone
laterality, location, or size (p>0.05). Median BMI values were 23 (19-24), 27 (25-29.8) and 31.2
(30-34.7) for normal weight, overweight and obese groups, respectively. SFR were 79.2% (61),
77% (124), and 75% (18) for the normal, overweight, and obese groups, respectively (p>0.05).
No significant differences were observed in operative time, fluoroscopy time, length of hospital
stay, or nephrostomy duration between the groups (p>0.05). The rates of minor and major
complications were similar among all groups (p>0.05).

Conclusion: Obesity does not appear to significantly impact the outcomes of supine PCNL,
including operative time, SFR, or complication rates. These findings suggest that with
experienced surgeons, supine PCNL is a reliable and efficient treatment option for obese
patients, though further prospective studies are needed to confirm these results.

Keywords: supine percutaneous nephrolithotomy; kidney stone; obesity; body mass index


Abstract

Objective: This study aimed to evaluate the impact of obesity on the outcomes of supine
percutaneous nephrolithotomy (PCNL) at a tertiary university hospital. Understanding surgical
outcomes in obese patients, given their rising prevalence and urolithiasis risk, is crucial for
optimizing treatment strategies.

Material and Methods: This retrospective study included data from 256 patients aged 18 and
older who underwent PCNL in the Galdakao-Valdivia position between July 2021 and July 2024
at a tertiary care hospital. Patients were divided into three groups according to their body mass
index (BMI): normal weight (BMI: 18-24.9 kg/m²), overweight (BMI: 25-29.9 kg/m²), and obese
(BMI: 30-34.9 kg/m²). Demographic data, stone characteristics, operative time, fluoroscopy
time, hospital stay, nephrostomy duration, stone free rates (SFR), and complications were
analyzed and compared among the groups.

Results: No significant difference was found among the groups regarding age, sex, stone
laterality, location, or size (p>0.05). Median BMI values were 23 (19-24), 27 (25-29.8) and 31.2
(30-34.7) for normal weight, overweight and obese groups, respectively. SFR were 79.2% (61),
77% (124), and 75% (18) for the normal, overweight, and obese groups, respectively (p>0.05).
No significant differences were observed in operative time, fluoroscopy time, length of hospital
stay, or nephrostomy duration between the groups (p>0.05). The rates of minor and major
complications were similar among all groups (p>0.05).

Conclusion: Obesity does not appear to significantly impact the outcomes of supine PCNL,
including operative time, SFR, or complication rates. These findings suggest that with
experienced surgeons, supine PCNL is a reliable and efficient treatment option for obese
patients, though further prospective studies are needed to confirm these results.

Keywords: supine percutaneous nephrolithotomy; kidney stone; obesity; body mass index