scholarly journals UPPER URETERIC STONES

2018 ◽  
Vol 25 (01) ◽  
pp. 10-15
Author(s):  
Khalid Hussain ◽  
Attiqur Rehman Khan ◽  
Maria Tariq ◽  
Imran Ameen ◽  
Muhammad Khalid Butt
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Pneumatic Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Male Preponderance ◽  
Dj Stent ◽  
Risk Of Treatment ◽  
Free Status

Objectives: Compare the efficacy of Extracorporeal Shock Wave Lithotripsy withPneumatic Lithotripsy in the management of upper ureteric stones. Settings: Department ofUrology, Lahore General Hospital, Lahore. Duration of Study: From November 2008 to August2009. Results: In our study, the patients were divided into two groups ie; Extracorporeal ShockWave Lithotripsy group (ESWL) and Pneumatic Lithotripsy group (PnL). The mean age inPneumatic Lithotripsy (PnL) was 39+15.23 years, whereas mean age was 40.6+14.62 years inExtracorporeal Shock Wave Lithotripsy group (ESWL). In Extracorporeal Shock Wave Lithotripsygroup (ESWL), 38(76%) patients were male and 12(24%) patients were female while numberwas 34(68%) and 16(32% in Pneumatic Lithotripsy group (PnL) respectively. In both groups,there was male preponderance. In ESWL group, majority of patients were treated as outdoorpatients. 95% of them received intramuscular analgesia where as 5% required intravenoussedation. All patients were followed at two weekly interval up till 6 weeks. Fifty patients requiredmore than 125 sessions of ESWL with mean shock waves 2960+222.23 at at mean energy6.46+0.503kv, 2952+327.77 at 6.45+0.504 kv and 2842+410.03 at 6.76 0.436 kv at 2, 4 and 6weeks respectively. The partial clearance was achieved in 34 patients at 2 weeks, 26 patientsat 4 weeks and 5 patients at 2 weeks. Stone free status at 2 weeks, 4 weeks and 6 weeks were18%, 40% and 84% respectively. In Pneumatic Lithotripsy group (PnL) all of the 50 patientswere given general anesthesia. DJ stent was placed in all patients after the procedure for sixweeks follow up. 42(84%) of patients received shots of Pneumatic Lithotripsy on pulse modewhile in 8(16%) patients, shots were on continuous mode. The partial clearance was achieved in5(10%), 3(6%) and 2(4%) patients at 2, 4 and 6 weeks respectively. Stone free status was 48%,52% and 54% at 2, 4 and 6 weeks respectively. In 20(40%) patients, stone migrated into calyces.Only in 1(2%) patients, there was no effect on stone. All patients in both groups were neededtwo weekly follow up till six weeks. Stone clearance was 84% in Extracorporeal Shock WaveLithotripsy (ESWL) group while it was 54% in Pneumatic Lithotripsy group (PnL), p<0.001.Conclusion: Extracorporeal Shock Wave Lithotripsy offers higher stone free rates with minimalinvasiveness and high safety compared to Pneumatic Lithotripsy, which provides immediatehigh stone free rates, but with high risk of treatment failure.

scholarly journals Extracorporeal Shock Wave Lithotripsy and Combined Therapy in Children: Efficacy and Long-Term Results

2021 ◽  
Vol 9 ◽  
Author(s):  
Laura Burgos Lucena ◽  
Beatriz Fernández Bautista ◽  
Alberto Parente Hernández ◽  
Ruben Ortiz Rodríguez ◽  
Jose María Angulo Madero
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Combined Therapy ◽  
Percutaneous Approach ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Free Status

Background: Extracorporeal shock wave lithotripsy (ESWL) is nowadays the first choice for the treatment of upper urinary tract stones smaller than 2 cm, considering its low complications and high success rate.Aim: To present an update of the current situation of ESWL treatment and to analyse our series of patients and the efficacy of combined lithiasis treatment in different locations and sizes.Patients and Method: Retrospective study including patients with urolithiasis treated with ESWL between 2007 and 2019. Collected data included: gender and age at treatment, presentation symptoms, imaging studies, stone location and size, complications and stone clearance. Success was defined as stone-free status or the presence of clinically insignificant residual fragments (&lt;4 mm after 3 months follow-up). Patients with residual stones larger than 4 mm after 3 months were programmed for another ESWL session or received a combined sandwich therapy, followed by URS or percutaneous approach.Results: Between 2007 and 2019, 37 patients presented a total of 41 lithiasis episodes that were treated with ESWL sessions. Median age at first procedure was 9 years old (1–17) and median follow-up time was 6 years (3–12). Stones were located in the renal pelvis, followed by the lower, middle and upper calyx, proximal ureter, and 51% of our patients had multiple lithiasis. Median stone size was 12 mm (5–45), the main component being calcium oxalate (34%). During immediate postoperative period, 8 patients (19%) presented complications: renal colic, hematuria and urinary tract infection. After the first ESWL, 41% of the patients (n = 17) were stone-free. Out of the 24 residual lithiasis episodes (58%), three patients (7%) underwent a second ESWL session. In the remaining 19 patients, ESWL was combined with URS or percutaneous approach to achieve complete stone clearance. Overall stone free status after combined therapy was 95% (n = 39).Conclusion: These data support that ESWL is an effective minimally invasive technique, with low cost and morbidity, reproducible and safe for the treatment of stone disease in children. Even though lithiasis size seems to be a significant factor in ESWL success, in combination with other lithotripsy procedures it can reach very high rates of stone clearance.

scholarly journals To Compare the Effectiveness of Transurethral Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy: In treatment of Lower Ureteric Stones

1969 ◽  
Vol 11 (4) ◽  
pp. 223-229
Author(s):  
Siddique Ahmad ◽  
Jamshed ◽  
Ameroon Shah ◽  
Riaz Ahmad Khan ◽  
Muhammad Kalim ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Pneumatic Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Ureteric Calculi ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: One of the most common complaint in the ER is colic due to Ureteric calculi. They usually pass out but stones > 5mmmay require intervention. ESWL and TPL are one of the treatment options.Objectives: To compare the effectiveness of transurethral pneumatic lithotripsy (TPL) and extracorporeal shock wavelithotripsy(ESWL) in treatment of lower ureteric stones.Material and Methods: Over period of six months a group of 70 patients presenting with ureteric calculi were randomly allocated intwo groups. Group Aunderwent TPL while Group B ESWL. Follow up was done to determine the effectiveness with regards to stoneclearance.Results: The mean age of the whole study sample was 35.6 + 8.5 years. The difference between mean age of both groups wasstatistically not significant (p 0.665). there were 70% males compared to 30% females in the overall sample and the difference ofgender across both groups was comparable (p 0.192). The mean size of stone of the whole study sample at presentation was 6.4 +2.5mm and the duration of illness was 4.8 + 1.8months. On follow up, the effectiveness of the procedure in terms of stone clearancewas recorded in 88.6% of TPL group and 77.1% of ESWL group (p 0.205).Conclusion: TPL is comparable to the ESWL in terms of its effectiveness for ureteric calculi of size less than or equal to 10mm.More research trials need to be done for conclusive outcome.Key Words: Urolithiasis, ureteric calculi, transurethral pneumatic lithotripsy, extracorporeal shock wave lithotripsy, stoneclearance

scholarly journals Efficacy of Percutaneous Nephrolithotomy in the Treatment of Renal Calculi of 10 to 20 MM Size: A Comparison With Extracorporeal Shock Wave Lithotripsy

2020 ◽  
Vol 21 (2) ◽  
pp. 98-104
Author(s):  
Muhammad Mahmud Alam ◽  
Mohammad Rezaul Karim ◽  
Mohammad Ohiduzzaman Khan ◽  
Mohammad Mukhlesur Rahman ◽  
Mahfuja Asma ◽  
...  
Keyword(s):  
Shock Wave ◽  
Percutaneous Nephrolithotomy ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Renal Calculi ◽  
Post Procedure ◽  
Extracorporeal Shock Wave ◽  
Significant Difference

Background: Stones in the urinary tract is a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) is also widely applied. There is a trend of using ESWL for treatment of renal stones smaller than 1 cm and PCNL in those with stones greater than 2 cm. Nevertheless, no consensus regarding treatment of renal stones between 1 to 2 cm stones. The objective of this prospective study was to compare the results of ESWL and PCNL for treatment of 1 to 2 cm renal stones. Method : This is a quasi experimental study. This study was conducted to compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) in treating 10 to 20 mm sized renal stone among the Bangladeshi population. This prospective study conducted between the periods of September, 2011 to August, 2012 in the department of urology, Bangabandhu Sheikh Mujib medical university (BSMMU) Hospital. All the patients attending the urology outpatient clinic with 10 to 20mm renal calculi were the study population. A total of 70 subjects were enrolled for this study and they were equally divided into two groups so that each group had 35 subjects. The one group received PCNL whereas the other group received ESWL. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-15). Results: There is no statistically significant difference in regarding age, sex, stone side(lt. or rt.), the distribution of stone (upper, middle and lower calyx) and size between the groups (p>0.05). At 3 month follow up among the patients in ESWL group stone cleared and not cleared were 25(71.4%) and 10(28.6%) respectively and at 3 month follow up among the patients in PCNL group stone cleared and not cleared were 33(94.3%) and 2(5.7%)respectively. There is statistically significant difference in stone clearance rate at 3 month follow up between the groups (p<0.05). All patients in ESWL group developed post procedure haematuria 35(100.0%). Other post procedure complications among the ESWL group pain, fever and steinstrasse were 12(34.3%), 07(20.0%) and 03(08.6%) respectively. Common post procedure complications among the patients of PCNL group pain, haematuria and fever were 11(31.4%), 33(94.3%) and 13(37.1%) respectively. Other post procedure complications in PCNL group were vomiting (8.6%), urinary leakage (5.7%), wound infection (11.4%) and urinary cutaneous fistula (5.7%). There was no statistically significant difference post procedure pain, haematuria and fever between the groups (p>0.05), but statistically significant difference observed in steinstrasse and wound infection between the groups (p<0.05). Mean±SD of hospital stay among the patients of ESWL group and PCNL group was 1.37±0.65 and 4.34±1.43 days respectively. There is statistically significant difference in hospital stay between the groups (p<0.05). Conclusion: Though some specific complications which can be treated conservatively are more in PCNL group it may be concluded that the treatment with PCNL is better option than ESWL among the patients having renal calculi 10 to 20 mm. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.98-104

scholarly journals COMPARISON OF THE SUCCESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) WITH AND WITHOUT DJ STENTING IN PROXIMAL URETERIC STONE

2020 ◽  
Vol 11 (2) ◽  
pp. 21-24
Author(s):  
Dr. Mudassar Saeed Pansota
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
P Value ◽  
Ureteric Stone ◽  
Extracorporeal Shock Wave ◽  
Dj Stent ◽  
Group A ◽  
Group B ◽  
Average Size

BACKGROUND & OBJECTIVE: There is disagreement in the use of ureteral double-J stent before the extracorporeal shock wave lithotripsy (ESWL), although most of the urologists suggest using stent in shock wave lithotripsy technique for stones bigger than 20mm, for preventing the risk of developing steinstrasse. To compare the success of ESWL with and without DJ stenting in proximal ureteric stone. METHODOLOGY: A total of 60 patients form both genders, between 15 to 55 years of age, with a single proximal ureteric stone, were included. Patients with solitary functioning kidney, multiple stones, pregnancy, pyonephrosis and sepsis were excluded. In Group-A, ESWL without DJ stenting was completed while in Group-B, ESWL with DJ stent placement was done. In all patients, at least 4 sessions were done fortnightly. Patients were followed regularly and final success was noted after one month of completion of ESWL sessions. RESULTS: The mean age was 36.85 ± 8.61 years. From 60 patients, 29 (48.33%) were men and 231 (51.67%) were women.Mean body mass index (BMI) was 28.30±2.20 kg/m . The average size of the stone was 12.47 ± 2.57 mm. Success (according to stone removal) of Group-A (ESWL without DJS) was seen in 26 (86.67%) patients while in Group-B (ESWL with DJS) was seen in 16 (53.33%) patients with P-value of 0.005. CONCLUSION: This study concluded that success (in terms of stone clearance) of extracorporeal shock wave lithotripsy (ESWL) without DJ stenting is higher compared to with DJ stenting in upper ureteric stone.

Hypertension after Extracorporeal Shock Wave Lithotripsy: Long Term Follow Up

1994 ◽  
pp. 529-531
Author(s):  
G. Zanetti ◽  
A. Trinchieri ◽  
E. Montanari ◽  
A. Guarneri ◽  
E. Austoni ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Long Term Follow Up
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