Diagnostic value of multidetector computed tomography for detection of complication after extracorporeal shock-wave lithotripsy

Abstract

Background Urolithiasis represents one of the most common urogenital disorders. Extracorporeal shock-wave lithotripsy (ESWL) has changed the management of urolithiasis. ESWL has many complications, including cardiac dysrhythmia, bacteriuria, bleeding, steinstrasse, renal colic, and urosepsis. Multidetector computed tomography (MDCT) allows reliable detection and quantification of post-ESWL complications. Aims The aim of this work was to evaluate post-ESWL sequel by CT and to rule out complications. Patients and methods In total, 30 patients with renal stones received treatment with ESWL. Patients came after undergoing ESWL procedure and suffering from clinical complaints to the Department of Diagnostic Radiology in Tanta University Hospital examination center. Results All patients included in our study were evaluated by MDCT to detect complications after ESWL. We found that 10 cases had multiple stone fragments along the course of the ureter that was called steinstrasse. Urinary-tract infections in six (20%) cases. Two cases had signs of inflammation with steinstrasse. Six cases had renal hematoma. We found a significant value. No significant value between the incidence of complications and systolic blood pressure and also diastolic blood pressure. We found significant differences between the incidence of complications and high fasting blood sugar, especially urinary-tract infection. MDCT-diagnosed pyelonephritis has high white blood cell count in urine more than 100. Red blood cell significantly increased in urine analysis of cases with renal hematoma and pyelonephritis. Conclusion MDCT is considered the most accurate noninvasive imaging tool not only for diagnosis of urinary-tract stone but also detection of complications after ESWL.