Extracorporeal shock wave lithotripsy is effective in treating single melamine induced urolithiasis in infants and young children

Correlative investigation between routine clinical parameters of dual-energy computed tomography and the outcomes of extracorporeal shock wave lithotripsy in children with urolithiasis: a retrospective study

PURPOSE

To evaluate the associations of DECT parameters with extracorporeal shock wave lithotripsy (ESWL) outcomes in pediatric patients.

METHODS

A retrospective study of consecutive patients with calculi who underwent ESWL and DECT in our hospital was performed in 2011-2019. The primary outcome was DECT imaging's correlation with ESWL outcomes. The secondary outcome was to determine DECT parameters independently predicting ESWL outcomes, including stone-free (SF) and residual stone (RS) statuses.

RESULTS

The study included 207 patients. The mean CT attenuations at 140 kVp, 80 kVp, and 120 kVp and effective atomic number (Zeff) were significantly correlated with stone free (SF) and residual stone (RS) (P < 0.05). Areas under the curves (AUCs) of CT attenuations at 120 kVp, 80 kVp, 140 kVp, and dual-energy index (DEI) were 0.784 (95% CI 0.672-0.897), 0.780 (95% CI 0.677-0.884), 0.766 (95% CI 0.658-0.885), and 0.709 (95% CI 0.578-0.840) (all P < 0.05). With cutoffs of 882.5, 1330.5, 1042.5, and 0.103 for CT attenuations at 140 kVp, 80 kVp, 120 kVp, and DEI, respectively, sensitivities and specificities were 75.0% and 31.1%, 83.3% and 31.8%, 80.3% and 31.1%, and 58.3% and 44.7%, respectively.

CONCLUSION

Our results demonstrated that the parameters of DECT could be used to predict ESWL outcomes (especially the SF status) in children with urolithiasis. ESWL success can be accurately predicted by DECT, and it is hard to predict ESWL failure.

Extracorporeal shock wave therapy decreases the number of total and degranulated mast cells and alleviates pelvic pain in a rat model of prostatitis

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male urological disease characterized by chronic pelvic pain. Extracorporeal shock wave therapy (ESWT) has been used to treat patients with CP/CPPS, but the parameters used by ESWT are not uniformly determined. Herein, this study aims to assess the effects of ESWT with different energy flux densities on pelvic pain in CP/CPPS rats and to explore the mechanisms. A rat model of CP/CPPS was induced by intraprostatic injection of 1% carrageenan. ESWT with different energy flux densities (0.09, 0.20, 0.30, 0.40 mJ/mm²) was applied in the pelvic region of CP/CPPS rats once a week for 4 weeks. The results showed that compared with the other energy flux densities (0.09, 0.30, and 0.40 mJ/mm²), ESWT with 0.20 mJ/mm² exhibited a more powerful effect in alleviating pelvic pain and prostate damage. The therapeutic effect is associated with the reduction of the number of total and degranulated mast cells. Collectively, ESWT with 0.20 mJ/mm² achieved the optimal therapeutic effect in alleviating pelvic pain in CP/CPPS rats.