• Yasir Rasheed, Syed Muhammad Nazim, Maheen Zakaria, Muhammad Bin Nasir, and Sadia Khan.
• Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2023 Feb 1; 33 (2): 199204199-204.

ObjectiveTo prospectively evaluate ESWL (extracorporeal shock wave lithotripsy) outcomes and validate ESWL Score.Study DesignAn observational study.Place And Duration Of StudyThe Aga Khan University Hospital, from January 2021 to December 2021.MethodologyPatients with symptomatic, solitary, radio-opaque renal stone measuring <15 mm with normal renal functions were included in this study. Stone size <11mm, BMI <27 Kg/m2, and stone density <900 Hounsfield units (HU) were all given 1 point each to give a total ESWL Score between 0-3 to each patient. Patients were evaluated after 4-weeks for the outcome i.e. stone clearance and complications.ResultsA total of 146 patients were included in the study. Median values for age, stone size, BMI and stone density were 40 years, 8 mm, 27 Kg/m2, and 774 HU respectively. Post ESWL, 99 (68%) patients were stone-free while 47 (32%) patients had residual stones. The stone clearance increased with the increasing score: 50% for ESWL score 0, 55.6% for ESWL score 1, 66.1% for ESWL score 2, and 85.7% for ESWL score 3 (p=0.01). The area under the curve (AUC) of ESWL score was 0.655 with 95 % CI (p=0.001).ConclusionESWL Score is a useful predictor of the success of ESWL. It can help decide the individualised and appropriate modality of treatment and assist with patient counselling.Key WordsStone, Lithotripsy, Extracorporeal, Score, Shock wave, Outcome.

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