1538 SHOCKWAVE LITHOTRIPSY INDUCED PERINEPHRIC HEMATOMA: A MATCHED CASE-CONTROL ANALYSIS OF RISK FACTORS

Abstract

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal I1 Apr 20121538 SHOCKWAVE LITHOTRIPSY INDUCED PERINEPHRIC HEMATOMA: A MATCHED CASE-CONTROL ANALYSIS OF RISK FACTORS Andrew Fuller, Kirsten Foell, Carlos Mendez-Probst, Rasmus Leistner, Sumit Dave, and Hassan Razvi Andrew FullerAndrew Fuller London, Canada More articles by this author , Kirsten FoellKirsten Foell London, Canada More articles by this author , Carlos Mendez-ProbstCarlos Mendez-Probst London, Canada More articles by this author , Rasmus LeistnerRasmus Leistner London, Canada More articles by this author , Sumit DaveSumit Dave London, Canada More articles by this author , and Hassan RazviHassan Razvi London, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1307AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine the incidence of and evaluate potential risk factors for the development of symptomatic post-shock wave lithotripsy (SWL) perinephric hematoma (PNH) with the latest generation shock wave lithotripter. METHODS From April 2006 to August 2010, 6172 SWL treatments for proximal ureteral and renal stones were performed using the Storz Modulith SLX-F2 device. Data was collected prospectively for patient and treatment-related data. Hematomas were detected by imaging studies when patients developed suggestive signs or symptoms post-procedure. A matched case-control study was performed, with 4 controls matched for each hematoma case based on: sex, age (± 5 years), shock wave rate, energy and number, and no SWL within previous 6 months. Baseline characteristics were compared between the cases and controls using Student's t-test. A conditional logistic regression analysis was performed to assess the independent variables hypertension (intraoperative value ≥ 140/90), anticoagulant/antiplatelet drugs, obesity (BMI ≥ 30) and diabetes; the dependent variable was hematoma. RESULTS Following SWL, 21 patients (0.34%) developed clinically apparent PNH. The mean age was 55.2 years. Male sex was a risk factor for hematoma formation. Intraoperative hypertension (HR 3.302, 1.066 – 10.230, p = 0.0384), and anticoagulant/antiplatelet drugs (HR 4.198, 1.103 – 15.984, p = 0.0355) were significant risk factors. Obesity (p=0.1021) and diabetes (p=0.1043) were not. CONCLUSIONS The incidence of perinephric hematoma formation with the SLX-F2 was less than 1% and consistent with reports of earlier generation devices. Male gender, intraoperative hypertension, and the use of anticoagulant/antiplatelet drugs were identified as risk factors for hematoma formation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e622 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Fuller London, Canada More articles by this author Kirsten Foell London, Canada More articles by this author Carlos Mendez-Probst London, Canada More articles by this author Rasmus Leistner London, Canada More articles by this author Sumit Dave London, Canada More articles by this author Hassan Razvi London, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...