scholarly journals Extracorporeal Shockwave Lithotripsy: Initial Experience at Bahawalpur

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Mumtaz Rasool ◽  
Shafqat Ali Tabassum ◽  
Abid Hameed Sheikh ◽  
Fariha Mumtaz
Keyword(s):  
Kidney Stone ◽  
Shock Wave Lithotripsy ◽  
Shockwave Lithotripsy ◽  
Endoscopic Stenting ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Extracorporeal Shock Wave ◽  
Intracorporeal Lithotripsy ◽  
The One

Place of Study: American Kidney Stone Centre (AKSC), Bahawalpur, a private setup.Duration of Study: January 2005 to June 2007.Design of Study: Prospective, Observational.Material & Methods: A total of 250 patients were evaluated for ESWL results. The one session comprised of 1500-2500shocks with intermittent fluoroscopy with X-Ray focusing. A period of 7 – 10 days was given between two sessions. Theprocedure was repeated till the clearance of stone no matter what was the number of sessions. The complications like pain,colic, hematuria were addressed adequately and immediately. The development of steinstrasse was initially observed and fewrequired manipulation. The stone size is the only matter of concern in few patients especially lower pole stones.Results: The stone clearance was achieved in 89% of patients. Auxillary procedures were required in 10.8% before ESWLand 9.6% of patients after ESWL. Which include Endoscopic stenting and manipulation with uretero-renoscopy andintracorporeal lithotripsy. Prophylactic insertion of DJ stenting reduced complication rate and incidence of steinstrasse.Conclusion: ESWL can be safely recommended for patients of urolithiasis irrespective of age and stone size with promisingresults of stone clearance and patient acceptance.Key Words: ESWL-Extracorporeal shock wave lithotripsy, URS-Ureterorenoscopy. ICL-Intracorporeal lithotripsy.

scholarly journals Shockwave lithotripsy for urolithiasis: a 12-month analysis of referral data to a metropolitan Australian Hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 625
Author(s):  
Joseph Swaminadan Jaya ◽  
Phi Nguyen ◽  
Henley Tran ◽  
John Bailie ◽  
John Brookes ◽  
...  
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Outpatient Clinics ◽  
Shockwave Lithotripsy ◽  
Stone Size ◽  
Stone Clearance ◽  
X Ray ◽  
Planning Meeting ◽  
Direct Referral ◽  
Australian Hospital

Background: Extracorporeal shockwave lithotripsy (SWL) is still an important option in the treatment of renal tract stones. SWL is not without its limitations and alternatives should be considered. This study investigates the referral data to a new SWL planning meeting to identify reasons why SWL was not offered.Methods: A review of 12 months of data prospectively collected at a weekly stone meeting was supplemented with a retrospective chart analysis to identify the source of all referrals for SWL. The principal reason for diverting a patient to other stone management was noted.Results: 142 patients (median age 52 years) were referred for SWL over the 12-month period. SWL was not recommended in 40 (28.2%) patients. SWL was most commonly contraindicated due to excessive stone size±position (32.5%), anatomical complexity (25.0%) and radiolucency on x-ray (10.0%). The majority of patients who were diverted away from SWL were referred from an emergency department (32.5%) and the general urology clinics (20.0%).Conclusions: A significant portion of patients referred for SWL prove unsuitable for this method of stone clearance. This highlights an educational gap amongst clinicians regarding the indications and more importantly contraindications for SWL. Only 6.3% of total referrals originated from general practice suggesting a lack of awareness of the process of direct referral for SWL. Improving this with guidelines will relieve demand in outpatient clinics and help streamline patient care.

scholarly journals TO COMPARE THE EFFICACY OF URETEROSCOPIC LITHOTRIPSY VERSUS EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY IN THE TREATMENT OF PROXIMAL URETERIC STONES OF SIZE BETWEEN 10MM TO 15MM.

1969 ◽  
Vol 5 (2) ◽  
pp. 658-662
Author(s):  
MUHAMMAD ARSHAD IRSHAD KHALIL ◽  
IAZ AHMAD KHAN ◽  
SIDDIQUE ADNAN
Keyword(s):  
Urinary Tract ◽  
Kidney Diseases ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Treatment Modalities ◽  
Shockwave Lithotripsy ◽  
Stone Size ◽  
Ureteroscopic Lithotripsy ◽  
Stone Clearance ◽  
Extracorporeal Shockwave ◽  
Extracorporeal Shock Wave

BACKGROUND: The overall probability that an individual will form stones varies in different regionsof the world. The risk of having urinary tract stones in the developed country populations is between 10-15%. The prevalence of urinary tract stone disease is 13% for adult males and 7% among the females.Most of the patients with ureteric stones present with colicky pain, however some may be asymptomaticand are identified on routine assessment. Large stones typically require active treatment. Stones that donot pass can be removed by different treatment modalities such as Extracorporeal shock wave lithotripsy(ESWL), Ureteroscopic lithotripsy (URSL) and open or laparoscopic ureterolithotomy.OBJECTIVE: To compare the efficacy of Ureteroscopic lithotripsy versus extracorporeal shockwavelithotripsy in the treatment of proximal ureteric stones of size between 10mm to 15mm.MATERIALS AND METHODS: This was a randomized control trial of 138 human subjects,conducted at Department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex,Peshawar. Total sample size was based on the previously reported stone clearance rates for proximalureteric stones (88% URSL12 and 67.5% for ESWL11), 95% confidence interval and power of 90%.RESULTS: In this study mean age was 47.36 years SD +15.4. Fifty nine percent patients were male and41% patients were female. Eighteen percent patients had stone size 10mm, 19.6% patients had stone size11mm, 19.6% patients had stone size 12mm, 16.7% patients had stone size 13mm, 13.6 patients hadstone size 14mm, 11.6% patients had stone size 15mm. ESWL was effective in 65.2% and was notsuccessful in 34.8%, while in the URSL group 84.1% were treated successfully and in 15.9% patientswith proximal ureteric stones the stone clearance efficacy was not effective.CONCLUSION: Both URSL & ESWL are well accepted minimally invasive modalities of treatmentfor proximal ureteric stones. We conclude that URSL has yielded superior results as compared to theESWL group in treatment of patients with proximal ureteric stones of size 1-1.5cm.KEY WORDS: Ureteroscopic lithotripsy, extracorporeal shockwave lithotripsy, proximal ureteric stones.

scholarly journals Ultrasound-guided Paravertebral Block Versus Intravenous Sedative Analgesic using Midazolam /Fentanyl in Patients Undergoing Extracorporeal Shock Wave Lithotripsy

2021 ◽  
pp. 1-10
Author(s):  
Fatma M. Elaiashy ◽  
Mohamed M. Abu Elyazd ◽  
Ahmed A. Eldaba ◽  
Tarek A. Gameel
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Paravertebral Block ◽  
Ultrasound Guided ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Fentanyl Group

Background: Thoracic paravertebral block (TPVB) produces ipsilateral somatic and sympathetic nerve blockade in multiple contiguous dermatomes both above and below the site of injection.  The Aim of This Study: was to compare the effectiveness of ultrasound-guided TPVB versus intravenous (IV) sedative analgesic using midazolam / fentanyl in patients undergoing extracorporeal shock wave lithotripsy (ESWL) procedure. Patients and Methods: This prospective, randomized study was carried out on sixty patients aged 20-60 years, with radio-opaque renal stone not more than1.5cm. TPVB group (30 patients) received ipsilateral ultrasound-guided TPVB at the level T9-T10 using bupivacaine 0.25% (20 mL) about 30 minutes before the ESWL. Midazolam/fentanyl group (30 patients) received sedatives analgesic drugs using IV midazolam (0.05 mg / kg) and fentanyl (1 µg/kg) about 5 min before the ESWL. The VAS score during and 30 min post procedure, total dose of rescue analgesic consumption during ESWL procedure, the success rate of ESWL, the time needed to stone clearance, patient and operator satisfaction scores were recorded. Result: During and after ESWL procedure, the VAS scores were significantly higher in midazolam/fentanyl group than TPVB group (P < 0.05). The number of patients required rescue analgesic during ESWL was significantly higher in midazolam/fentanyl group compared to TPVB group (P < 0.05).The success rate of ESWL was insignificantly different between both groups (P > 0.05). The time needed to stone clearance was significantly shorter in TPVB group compared to midazolam/fentanyl group (P < 0.05). Conclusions: Ultrasound-guided TPVB provided more effective analgesia with reduced number of ESWL sessions and shorter time to renal stone clearance than IV midazolam/fentanyl.

scholarly journals Extracorporeal shock wave lithotripsy in the management of upper urinary tract stone: a single institute experience

2018 ◽  
Vol 1 (2) ◽  
pp. 102-104
Author(s):  
Dhruba Bahadur Adhikari ◽  
David Shrestha ◽  
Anup Shrestha
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Success Rate ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Hounsfield Unit ◽  
Upper Urinary Tract ◽  
Stone Size ◽  
Extracorporeal Shock Wave ◽  
Urinary Tract Stone

Introduction: The aim of the study was to observe the success rate of extracorporeal shock wave lithotripsy (ESWL) in the management of upper urinary tract stones. Materials and Methods: This retroprospective study was conducted in Pokhara Kidney stone Centre, Pokhara, Kaski, Nepal from January 2017 to January 2018. Seventy nine patients were selected in this study with upper urinary tract stone, size less than 20 mm. Results: Seventy four (93.67%) patients were successfully treated in initial use of shock wave and 5 (6.32%) patients required repetition. Conclusion: Overall satisfactory success rate was observed using ESWL for the upper urinary tract stone. Careful selection of patient, stone size and Hounsfield unit (HU) is advisable.

scholarly journals Effects of hydrochlorothiazide on kidney stone therapy with extracorporeal shock wave lithotripsy

2014 ◽  
Vol 6 (3) ◽  
pp. 208 ◽  
Author(s):  
Yousef Rezaei ◽  
Ali Tehranchi ◽  
Parisa Tehranchi ◽  
Farzad Abedi ◽  
Mansour Alizadeh ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Kidney Stone ◽  
Shock Wave Lithotripsy ◽  
Extracorporeal Shock Wave

scholarly journals Efficacy of Combined Endoscopic Lithotomy and Extracorporeal Shock Wave Lithotripsy, and Additional Electrohydraulic Lithotripsy Using the SpyGlass Direct Visualization System or X-Ray Guided EHL as Needed, for Pancreatic Lithiasis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ken Ito ◽  
Yoshinori Igarashi ◽  
Naoki Okano ◽  
Takahiko Mimura ◽  
Yui Kishimoto ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Direct Visualization ◽  
Visualization System ◽  
X Ray ◽  
Electrohydraulic Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Pancreatic Lithiasis ◽  
Spyglass Direct Visualization System

Introduction. To evaluate the efficacy of combined endoscopic lithotomy and extracorporeal shock wave lithotripsy (ESWL), and additional electrohydraulic lithotripsy (EHL) as needed, for the treatment of pancreatic duct stones, we retrospectively evaluated 98 patients with chronic pancreatitis and pancreatic lithiasis.Methods. For the management of main pancreatic duct (MPD) stones in 98 patients, we performed combined endoscopic treatment (ET)/ESWL therapy as the first treatment option. When combined ET/ESWL was unsuccessful, EHL with the SpyGlass Direct Visualization system or X-ray guided EHL was performed. Outpatient ESWL was reserved as one of the final treatment options.Results. Fragmentation was successful in 80 (81.6%) patients as follows: combined ET/ESWL: 67 cases; SpyGlass EHL: 4 cases; X-ray guided EHL: 3 cases; and outpatient ESWL: 6 cases. Successful outcome was obtained by combined ET/ESWL in 67 of the 98 patients (74.5%), by EHL in 7 of 14 patients (7.1%), and by outpatient ESWL in 6 of 6 patients (6.1%). Negotiating the guidewire through a severe MPD stricture was significantly associated with a higher rate of stone fragmentation (P=0.0003).Conclusions. In cases where combined ET/ESWL was not successful for stone clearance, EHL using the SpyGlass system or X-ray guided EHL was effective in cases where the guidewire could be negotiated through the MPD stricture and it increased the fragmentation rate.

scholarly journals Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique

2015 ◽  
Vol 9 (7-8) ◽  
pp. 494 ◽  
Author(s):  
Giovanni Scala Marchini ◽  
Fábio Cesar Miranda Torricelli ◽  
Eduardo Mazzucchi ◽  
Miguel Srougi ◽  
Manoj Monga
Keyword(s):  
Shock Wave ◽  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Treatment Modalities ◽  
Flexible Ureteroscopy ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Intracorporeal Lithotripsy ◽  
Leg Position

The management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy, cystolithopaxy, rigid or flexible ureteroscopy with intracorporeal lithotripsy, percutaneous nephrolithotomy, open surgery, and a combination of those methods. In this study we describe the management of severe forgotten encrusted ureteral stents in 3 female patients using a prone splitleg position. This position allows us to effectively treat any site and degree of stent encrustation in a single-session approach with the patient in the same position during the whole procedure. All patients were rendered stent and stone free. No complications occurred.

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