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 Prognostic implications of double J ureteral stenting in patients with renal stones undergoing extracorporeal shockwave lithotripsy

2017 ◽  
Vol 5 (9) ◽  
pp. 3831
Author(s):  
Rahul Jain ◽  
Karthikeyan Raju ◽  
Rajandeep Singh Bali ◽  
Jagdish Chander ◽  
Sushanto Neogi
Keyword(s):  
Urinary Tract ◽  
Renal Stones ◽  
Renal Calculus ◽  
Extracorporeal Shockwave Lithotripsy ◽  
P Value ◽  
Shockwave Lithotripsy ◽  
Stone Clearance ◽  
Extracorporeal Shockwave ◽  
Double J Stent ◽  
Significant Difference

Background: Most patients with uncomplicated kidney stones can be successfully treated with extracorporeal shockwave lithotripsy (ESWL). Double-J ureteral stent is used to facilitate stone clearance, however double-J ureteral stents themselves may cause complications. Study conducted the study to know the exact role of double J stent in ESWL.Methods: 80 patients undergoing ESWL were divided into two groups, group A (n=40) double J stenting and group B (n=40) without double J stenting. Both groups were compared for stone fragmentation, stone clearance, number of shockwaves required for fragmentation, time required for passing through ureter, steinstrasse, Urinary Tract Infection.Results: Both the groups were comparable for age, sex, stone size and stone location distribution. There was no significant difference in clearance of stone and no. of shockwaves received for clearance in both the groups. The overall incidence of steinstrasse between the two groups was insignificant with a p value of 0.644. The incidence of UTI was significantly higher in stented group (p value 0.032).Conclusions: Study recommend ESWL without double J stent in patients having solitary renal calculus of size < 2 cm. Double J stent predisposes the patient to multiple complications including urinary tract infection which increases the morbidity of the patient. Based on our study we conclude that double J stenting in patients of renal calculus of size < 2cm, prior to ESWL is not beneficial.

scholarly journals The reasons of unsatisfactory results of extracorporeal shock wave lithotripsy in patients with ureterolithiasis

2021 ◽  
pp. 48-53
Author(s):  
Oleksandr Vozianov
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Minimal Invasive ◽  
Diagnostic Methods ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Shockwave Lithotripsy ◽  
Aim Analysis ◽  
Extracorporeal Shockwave ◽  
Extracorporeal Shock Wave

The article dedicate to the problem of failure of extracorporeal shockwave lithotripsy in patients with ureterolithiasis and reveal the changes which appear in the ureter in the location of the stone.The aim. Analysis of the results of treatment in patients, suffering ureteric stones, using the ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy. Materials and methods. In 137 patients with ureteric stones, whom ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy was conducted, the symptoms of the disease, the diagnostic methods value, efficacy of surgical treatment and reasons of the failure of previous method of treatment were analyzed. Results. In 135 patients endoscopic removal of stones has been succeeded, in 2 patients because of total obliteration of the ureter, uretero-ureteral anastomosis has been performed. If the symptoms, with are characteristic of ureterolithiasis, persists up to one week stones don’t cause significant macroscopic changes to the ureter wall. If the stone persists in the ureter longer than a week we identified local appearing of oedema. Long–term (more than two months) ureteric stone persistence increase the risk of intramucosal “ingrowth” of the calculi greatly. Conclusion. The URS and ESWL are high effective and minimal invasive methods of surgical intervention for patients with ureterolithiasis, guaranteeing high level of postoperative “stone free rate”. Prolongation of the stone insertion time in the ureter causes the ureteric wall changes, complicating performance of minimal invasive interventions (ureterolithotripsy and extracorporeal shock–wave lithotripsy) and reduce its efficacy.

Emergency Extracorporeal Shockwave Lithotripsy for Acute Renal Colic Caused by Upper Urinary-Tract Stones

2005 ◽  
Vol 19 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Sergey Kravchick ◽  
Igor Bunkin ◽  
Eugeny Stepnov ◽  
Ronit Peled ◽  
Leonid Agulansky ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Colic ◽  
Upper Urinary Tract ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Shockwave Lithotripsy ◽  
Extracorporeal Shockwave ◽  
Acute Renal Colic ◽  
Urinary Tract Stones

scholarly journals Outcome of Extracorporeal Shockwave Lithotripsy as Monotherapy in Upper Urinary Tract Lithiasis

2021 ◽  
Vol 1 (2) ◽  
pp. 38-41
Author(s):  
Dipak Kumar Thakur
Keyword(s):  
Urinary Tract ◽  
Success Rate ◽  
College Teaching ◽  
Upper Urinary Tract ◽  
Extracorporeal Shockwave Lithotripsy ◽  
Shockwave Lithotripsy ◽  
Female Ratio ◽  
Extracorporeal Shockwave ◽  
Urinary Tract Calculi ◽  
Upper Urinary Tract Calculi

Introduction: Due to its non-invasive nature, extracorporeal shockwave lithotripsy (ESWL) is the preferred treatment modality for uncomplicated renal and ureteral stone < 20 mm in diameter. The success rate of it ranges from 46% to 91% depending on various factors. Objective: To assess the outcome of ESWL as monotherapy in uncomplicated solitary renal and upper ureteric calculus ranging from 10mm to 20mm. Methods: In this retrospective study, the records of 34 patients who underwent Extracorporeal shockwave lithotripsy ESWL inBirat Medical College – Teaching Hospital over a period of one and a half years were reviewed to assess the outcome in terms of stone free rate and complication rate. Results: Mean age of the patients was 30.57±8.44 years and mean calculus size was 14.47±2.68 mm (range 10-20mm). The male and female ratio was 2:1. The success rate was higher for pelvic (83.33%) and upper calyceal (75%) and upper ureteric calculi (75%) compared to other calyces. Clinically significant residual fragment (CSRF) was the most common problem after ESWL (23.33%) at three months after the procedure. Conclusions: The outcome of ESWL as monotherapy for upper urinary tract calculi is acceptable in selected cases three months after the procedure. Keywords: Extracorporeal shockwave lithotripsy; outcome; upper urinary tract calculi.

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.

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