scholarly journals Evaluation of Factors Influencing Outcome of Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Stone in Adult

2020 ◽  
Vol 22 (2) ◽  
pp. 141-150
Author(s):  
Md Abdur Rakib ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed
Keyword(s):  
Shock Wave ◽  
Body Mass Index ◽  
Success Rate ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Results Of Treatment ◽  
Extracorporeal Shock Wave

Background: Renal stone disease is a common disorder with a prevalence ranging from 4-15% in different parts of the world. Modalities of kidney stone management includes drug therapy, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), Retrograde intrarenal surgery ureteroscopy (RIRS) and open surgery. ESWL is an acceptable technique and widely used because it is a non-invasive treatment and does not require anesthesia and usually done on an outpatient basis. Generally, ESWL is the treatment of choice for kidney stones <1 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50%-87%, depending on various factors. This study was conducted in order to evaluate thefactors affecting renal stones treatment by extracorporeal shock wave lithotripsy (ESWL).On the basis of different variables andfactors affecting the renal stones treatment by ESWL was evaluated. Objectives: To evaluate the factors affecting the outcome of Extracorporeal Shock Wave Lithotripsy (ESWL) in the treatment of renal stone in adults.To assess the success and failure rate by using ESWL for treatment of renal stone, to determine the effects of stone related factors to correlate the success rate with characteristics of the patients condition of the urinary tract and stone features; to observe the patient groups most likely to benefit from or fail an initial intervention with ESWL and to evaluate the post ESWL complications. Materials and methods: This is a prospective observational and analytical, hospital based study. Total 500 patients with single or multiple radio-opaque renal stones were treated with ESWL monotherapy using Siemens MODULARIS Variostarlithotriptor. This study was carried out inthe Department of Urology, Combined Military Hospital, Dhaka for a period of two years between 01 July 2015 to 31 July 2017. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<3mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density). Results: At 3-months follow-up, the overall success rate is 87.6%. Among them, repeated ESWL sessions were required in 266 patients (53.2%). Post-ESWL complications were recorded in 62 patients (12.4%). Using the chi-square test, only four factors have a significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (136/136; 100%) and lowest for those located in lower calyx 104/78; 75%) (p=0.001). Stone with a largest diameter of <10mm are associated with a success rate of 93.6% (307/328), compared to 76.2% (131/172) for those with a diameter of >10mm (p=0.001). The success rate was also higher for single stone (396/437; 90.6%) than multiple stones (42/63; 66.7%) (p=.001). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=.001). Other factors including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patients BMI. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.141-150

scholarly journals Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy

2018 ◽  
Vol 27 (1) ◽  
pp. 72-78
Author(s):  
Abul Hasanat Muhammad Afzalul Haque ◽  
Md Waliul Islam ◽  
Humayun Kabir Kallol ◽  
Md Shaful Alam Babul ◽  
Muhammad Habibur Rahman ◽  
...  
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Factors Affecting ◽  
Results Of Treatment ◽  
Extracorporeal Shock Wave ◽  
Stone Treatment

ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors. Aim: This study was conducted to evaluate Factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL). Materials and methods: The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density). Results: At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/ 84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. Conclusion: The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 72-78

scholarly journals Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy

2019 ◽  
Vol 46 (2) ◽  
pp. 1-6
Author(s):  
Abul Hasanat Muhammad Afzalul Haque ◽  
Md Waliul Islam ◽  
Humayun Kabir Kallol ◽  
Md Shaful Alam Babul ◽  
Muhammad Habibur Rahman
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Factors Affecting ◽  
Results Of Treatment ◽  
Extracorporeal Shock Wave ◽  
Stone Treatment

ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors. This study was conducted to evaluate factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL). The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number and radio density). At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI. Bangladesh Med J. 2017 May; 46 (2): 1-6

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 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.

Reno-ureteral stones treated by ESWL: First two years of experience

1997 ◽  
Vol 64 (4) ◽  
pp. 468-470 ◽  
Author(s):  
R. Sergi ◽  
F. Capocasale ◽  
C. Caccamo ◽  
A. Scopelliti
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Renal Stone ◽  
Renal Stones ◽  
Modern Medicine ◽  
Ureteral Stones ◽  
Years Of Experience ◽  
Endoscopic Procedures ◽  
Extracorporeal Shock Wave

– Extracorporeal shock-wave lithotripsy (ESWL) is one of the greatest steps forward that modern medicine has taken and has revolutionised treatment of reno-ureteral stones. The authors describe their first two years of experience in using a lithotriptor which, together with other surgical and endoscopic procedures, has enabled them to deal with all problems related to renal stone therapy. Three hundred and twenty sessions were carried out, 65% for renal stones and 35% ureteral. Stones in the kidney and upper ureter were crushed in 93.7% of cases and in the pelvic ureter in 59%. A second ESWL session was needed for 6 patients. No significant complications were encountered.

Tamsulosin treatment increases clinical success rate of single extracorporeal shock wave lithotripsy of renal stones

Urology ◽  
2005 ◽  
Vol 66 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Giovanni Luca Gravina ◽  
Alessia Mariagrazia Costa ◽  
Piero Ronchi ◽  
Giuseppe Paradiso Galatioto ◽  
Adriano Angelucci ◽  
...  
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Renal Stones ◽  
Extracorporeal Shock Wave

First Clinical Experience With Extracorporeally Induced Destruction of Kidney Stones by Shock Waves

2021 ◽  
pp. 193-196
Author(s):  
Michael S. Borofsky ◽  
Vincent G. Bird
Keyword(s):  
Shock Wave ◽  
Renal Function ◽  
Kidney Stones ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Case Series ◽  
Renal Stones ◽  
Surgical Interventions ◽  
Extracorporeal Shock Wave

This chapter reviews the findings of the initial case series of patients with renal stones treated with extracorporeal shock wave lithotripsy (ESWL) with 12 months of follow-up. In the majority of patients, the renal stones were broken up into fragments that could pass spontaneously, and only a few patients required surgical interventions. Renal function did not appear adversely impacted by the procedure.

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