Background: To investigate the relationship between ureteral wall thickness (UWT) and other variables of patients who underwent extracorporeal shock wave lithotripsy (SWL) in the primary treatment of the ureteral stone above the iliac crest level. Material and methods: A total of 147 patients aged 18 years and older, who underwent SWL in our clinic between December 2016 and December 2019 for the treatment of ureteral stones above the iliac crest level and had a non-contrast-enhanced abdominal computed tomography (NCCT) scans before the procedure were included in the clinical study. The results were evaluated at three months after SWL. The absence of residual fragments was considered as stone-free status, and the existence of any size residual fragment was considered as treatment failure. Results: In our study, the mean age of the patients was 42.4 ± 12.8 years, and the stone-free rate was 92.5%. The median transverse stone size was 7.5 mm (min 2.8 - max 15), and the median UWT was 4.2 mm (1 - 8.7). In the multivariate analysis, UWT (p = 0.002) and multiple stone presence (p = 0.027) were found to be independent factors affecting stone-free status. In the receiver operating characteristic (ROC) curve analysis, the optimal threshold value for UWT was determined as 5.25 mm. Conclusions: We found that UWT was the most important independent variable associated with increased failure in SWL treatment. The presence of multiple stones was another independent factor that increased failure rates. Using SWL technology through experience accumulated with the mechanical hardware of the machine, we can select patients who are more suitable for this treatment and improve treatment outcomes.

Background: Renal carcinoma and associated venous thrombosis cause-specific perioperative and postoperative challenges. We aimed to evaluate the factors affecting clinical outcomes in patients undergoing radical surgery due to renal carcinoma and associated venous thrombosis. Materials and methods: Hospital records were retrospectively reviewed to identify patients with renal carcinoma and associated venous thrombosis treated with radical surgery between 2006 and 2019. Preoperative, perioperative, and postoperative findings were analyzed to determine the associations between clinical and survival outcomes. Overall and disease-free survival was analyzed by the Kaplan-Meier method. Other associated prognostic variables were assessed using univariate and multivariate Cox regression analyses. Results: Thirty-three patients with renal carcinoma and associated venous thrombosis were enrolled for this study. There were 15 (45.4%) patients with level I, five (15.2%) with level II, eight (24.2%) with level III, and five (15.2%) with level IV venous thrombosis according to the Mayo Clinic classification system. The median follow-up was 35.6 months. In the univariate analysis, increased tumor size was associated with poor overall and disease-free survival. Preoperative clinic M1 disease was associated with poor overall survival. A high Mayo Clinic thrombus level was associated with poor disease-free survival. In the multivariate analysis, only tumor size and clinic M1 disease were independently correlated with poor overall survival. No independent statistically significant association was detected between thrombus level and survival outcomes. Conclusions: Although the thrombus level was not associated with overall and disease-free survival, tumor size and clinic M1 disease were found to have an independent prognostic impact on overall survival.