Breakdown of Kidney and Ureteral Stones Using Extracorporeal Shock Wave Lithotripsy in Zakho City

Shamoo K Al-Hakary

doi:10.4236/jmp.2015.67091

Abstract

In the present study, investigation of extracorporeal shock wave lithotripsy in Zakho City for breakdown kidney and ureteral stones has been carried out. The data were collected from the center of breakdown kidney stones in Zakho hospital. A total of 34 patients (25 male and 9 female) of ages ranged from 20 - 60 years were treated with ESWL. The patient harboring 24 renal stones and 10 ureteral stones of size ranged from 7 to 23 mm of almost patients are 8 mm and composed of calcium oxalate. The study has been conducted taking in to consideration the parameters (type, sizes, composition and location of stone as well as region and ages of patients, also power, number of shock wave and session). The results show that the number of shock wave decreases nearly exponentially with the ages of patients for calcium oxalate stone of size 8 mm under constant power 4 watt while it tends to increase according to increasing stones size for the patients of ages 20 - 30 years. The size of calcium oxalate stones decreases nearly exponentially with the patients’ ages for workers in Zakho city. Also for same size 8 mm of (calcium, phosphate, and oxalate) stones and different regions of zakho city, the number of shock waves decreases according to increasing ages of patients. Contrary to that for certain size of stones 8 mm, the number of shock wave starts to increase from uric acid to maximum value for calcium oxalate stone for the adult patients of age’s 22 up to 30 years. However for elders ages 30 - 60 years and different regions, the size of renal and ureteric stones increases from the minimum value for calcium, phosphate, oxalate to maximum value for calcium oxalate stone only. Uric acid stone requires minimum power to break, while the calcium oxalate needs maximum power to fragment due to its hardness composition. Later number of session of shock wave required for crushing each stones size increases according to increasing its size while its variation due to enhancing patients ages for calcium oxalate of size 8 mm results in nearly a decreasing exponential behavior.

Highlights

Extracorporeal shock wave lithotripsy (ESWL) is revolutionizing the treatment of kidney stones
The present study reports the results of application of (ESWL) in 34 patients (25 male and 9 female) with renal stones 24 in the left and right kidney and 10 in the ureter
A number of shock waves were needed to breakdown the stones reached to 18,000 with 6 session and power 5 watt for calcium oxalate stone of size 23 mm. This indication is well agreement with the previous studies states that the stones larger than 15 mm and calcium oxalate monohydrate stones usually require several ESWL procedures for clearance

Summary

Introduction

Extracorporeal shock wave lithotripsy (ESWL) is revolutionizing the treatment of kidney stones. This technology, which disintegrates stones in the kidney and other upper urinary areas through the use of shock waves, does not require an incision and is immensely attractive to patients who suffer from such stones [1]. Shock wave lithotripsy of gallstones began in 1985 [4] This technique is the most common treatment for kidney stone disease. The idea of this non-invasive procedure is to generate high intensity pressure waves (shock waves) outside the patient and to focus them on the stone to fragment it [5]. After endoscopic sphincterotomy of the pancreatic orifice, the stones are disintegrated by shock waves under fluoroscopic control using a kidney lithotripter (Dornier HM3)

Methods

Results

Conclusion