EXPERIENCE OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR KIDNEY AND UPPER URETERIC STONES BY ELECTROMAGNETIC LITHOTRIPTOR

Authors

  • Bakhtawar Gul Wazir
  • Mian Iftikhar ul Haq
  • Faheem ul Haq
  • Akhtar Nawaz
  • Ahmed Nawaz
  • Ikram ullah
  • Mohammad Jamil

Abstract

Background: Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive treatment of urinarystones which breaks them, by using externally applied, focused, high intensity acoustic pulse, intosmaller pieces so that they can pass easily through ureter. Shock wave generation, focusing, couplingand stone localisation by fluoroscope or ultrasound are the basic components of ESWL. ESWL hassome complications and is contraindicated in certain situations. The aim of this study was to evaluatethe effectiveness and safety of ESWL in kidney and upper ureteric stones by ElectromagneticLithotriptor. Methods: All adult patients with renal and upper ureteric stones having a diameter of up to1 Cm were included in the study. Basic evaluation such as history, examination, ultrasound andexcretory urography were performed. Electromagnetic lithotripsy was done and data were collected ona printed proforma from 1st January 2008 to 30th March 2009 in Institute of Kidney Diseases, Peshawar.Results: Out of a total of 625 patients 463 were male and 162 were female; 67.36% of patients werehaving renal stones, 23.84% upper ureteric and 8.8% both renal and ureteric stones. Complicationsnoted were renal colic in 9.76%, haematuria in 3.2%, steinstrasse in 2.72%, and fever in 1.12% ofpatients. The stone free rate was 89% and 7% of patients were having stone fragments <4 mm. ESWLfailed in 4% of patients. Conclusion: ESWL is a safe and effective way of treating kidney and upperureteric stones.Keywords: Extracorporeal shock wave lithotripsy (ESWL), kidney and upper ureteric stones

References

Abe T, Akakura K, Kawaguchi M, Ueda T, Lehikawa T, Ito H, et

al. Outocomes of shockwave lithotripsy for upper urinary tract

stones: a large scale study at a single institution. J Endourol

;19:768–73.

Chako J, Moore M, Sankey N, Chandhoke PS. Does a slower

treatment rate impact the efficacy of extracorporeal shock wave

lithotripsy for solitary kidney or ureteral stones? J Urol

;175:1370–3.

Kim FJ, Rice KR. Prediction of shockwave failure in patients

with urinary tract stones. Curr Opin Urol 2006;16:88–92.

Krambeck AE, Gettman MT, Rohlinger AL, Lohse CM,

Patterson DE, Segura JW. Diabetes mellitus and hypertension

associated with shock wave lithotripsy of renal and proximal

ureteral stones at 19 years of followup. J Urol 2006;175:742–7.

Lee C, Ugarte R, Best S, Monga M. Impact of renal function on

efficacy of extracorporeal shockwave lithotripsy, J Endourol

;21:490–3.

Lee YH, Tsai JY, Jiaan BP, Wu T, Yu CC. Prospective

randomized trial comparing shock wave lithotripsy and

ureteroscopic lithotripsy for management of large upper third

ureteral stones. Urology 2006;67:480–4.

Lindqvist K, Holmberg G, Peeker R, Grenabo L. Extracorporeal

shock wave lithotripsy or ureteroscopy as primary treatment for

ureteric stones: a retrospective study comparing two different

treatment strategies. Scand J Urol Nephrol 2006;40:113–8.

Madaan S, Joyce AD. Limitations of extracorporeal shock wave

lithotripsy. Curr Opin Urol 2007;17:109–13.

Micali S, Grande M, Sighinolfi MC, De Stefani S, Bianchi G.

Efficacy of expulsive therapy using nifedipine or tamsulosin,

both associated with ketoprofene, after shock wave lithotripsy of

ureteral stones.Urol Res 2007;35:133–7.

Skolarikos A, Alivizatos G, De La Rosette J. Extracorporeal

shock wave lithotripsy 25 years later: complications and their

prevention. Eur Urol 2006;50:981–90.

Weiland D, Lee C, Ugarte R, Monga M. Impact of shock wave

coupling on efficacy of extracorporeal shock wave lithotripsy. J

Edourol 2007;21:137–40.

Rajput AP, Khan S, Khan M, Din S, Haqnawaz. Present trend of

urolithiasis in Balochistan: a single center experience. J Coll

Physicians Surg Pak 2002;12:618–22.

Akhtar MS, Akhtar FK. Utility of the lithoclast in the treatment

of upper, middle and lower ureteric calculi. Surgeon 2003;

:144–8.

Butt AU, Khurram M, Ahmed A, Hasan Z, Rehman A, Farooqi

MA. Extracorporeal shock wave lithotripsy. J Coll Physicians

Surg Pak. 2005;15:638–41.

Keely FX Jr, Moussa SA, Smith G, Trolley DA. Clearance of

lower pole stones following shock wave lithitripsy: effect of

infundibulopelvic angle. Eur Urol 1999;36:371–5.

Arain GM, Malik SA, urinary calculas disease: a study of 267

cases at Sir Ganga Ram Hospital Lahore over 2 years. Biomedia

;13:38–41.

Tombolini P, Ruppolo M, Bellorofontae C, Zaatar C, Follini M.

Lithotripsy in the treatment of urinary lithiasis. J Nepbrol

;13:71–82.

Botoca MR, Bucuras V, Minciu R, Cumpanas A, Bioborean P,

Miclea F. ESWL-first line treatment in renal stones; Timisoara

Med J [ serial online] 2003;53(2): available from:

URL:http://www.tmj.ro/dump_articol.html?id_numar=2&id_arti

col=46

Mohayuddin N, Malik HA, Hussain M, Tipu SA, Shehzad

A, Hashmi A, et al. The outcome of extracorporeal shock wave

lithotripsy for renal pelvic stone with or without jj stent- a

comparative study. J Pak Med Assoc 2009; 59:143–6.

Maheshwari P, Andankar MG, Saple AL, Oswal AT.

Extracorporeal shock wave lithotripsy: complications and their

prevention. Bombay Hosp J [serial online] 2002;44(2):181–4.

Available at: http://www.bhj.org/journal/2002_4402_apr/

endo_181.htm.

Kamran T. Pneumatic lithotripsy for the management of ureteric

calculi. J Coll Physicians Surg Pak 2003;13:101–3.

Coz F, Ozivieto M, Bustos M, Lyng R, Stein C, Hinrichs A.

Extracorporeal shock wave lithotripsy of 2000 urinary calculi

with modulith SL: success and failure according to size and

location of stones. J Endourol 2000;14:239–6.

Ghafoor M, Halim A. Extracorporeal shock wave lithotripsy in

the treatment of ureteric stones: experience from Tawam

Hospital, United Arab Emirates. Ann Saudi Med 2002;22:18–21.

Downloads

Published

2010-06-01