Common and Uncommon Complications Related to ESWL

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is one of the most common urologic procedures performed today. Although it is a minimally invasive procedure, there has been a wide spectrum of injuries to the kidney and adjacent organs associated with ESWL. It is evident that ESWL produces a variety of acute clinical and subclinical complications that may have an effect on longterm blood pressure and renal function. In this chapter, we review the common and uncommon complications related to ESWL based on our multiinstitutional study of 6852 cases treated at Okayama University Hospital and its affiliated hospitals, as well as an intensive literature survey. In our study, we have analyzed the relationship between the incidence of acute symptomatic complications, i.e., post-ESWL fever as a common complication, and renal subcapsular hematoma as an uncommon one, and the kind of shockwave generator used. The overall incidence of post-ESWL fever and subcapsular hematoma was 4.2% and 0.6%, respectively. Electrohydraulic lithotriptors produced a higher incidence of these complications than electromagnetic and piezoelectric lithotriptors. In addition to subcapsular hematoma, we found a variety of other uncommon complications, and the clinical manifestations of these cases are reported along with literature reviews.