Extra-Corporeal Shock Wave Lithotriposy ( ESWL ) for Lower Ureteral Stone

Othman Jasim Mohammed Alzaidy,Baquba Teaching Hospital - Diyala- Iraq ,Reyad Ahmed Farhood

doi:10.26505/djm.19025670920

Abstract

Background: The optimal treatment of ureteral stones, particularly the lower ureteral stone, still controversial[5,13,15,18]. Objective: To assess the success rate of ESWL and tamsulosin in lower ureteral stone. Also to identify the parameters that affects the success rate of ESWL in the lower ureteral stone. Patients and Methods: Prospective study has been done on thirty-six patients sequentially selected from referred cases to the ESWL department in Sulaimania Teaching Hospital in the period from June, 2010 to January, 2011). All had radioopaque lower ureteric stone (from the lower border of sacroiliac joint to uretero-vesical junction). Stones ranging from (5.8 to14mm), twenty in the left side and sixteen in the right side , age ranging from (10 to 78 years), and only four of them had double J-stent (within 1 week before ESWL). Weekly follow up of all patients were done by U/S and twice-weekly by KUB for 6 weeks. Results: Twenty four cases (66.7%) were free of stone, five cases (13.9%) had residual stone and seven cases (19.4%) failed to respond, the most important two parameters that affect the result are the size of stone and number of sessions. Conclusion: ESWL is safe and useful, and it is considered to be the first favorable line of intervention for lower ureteric stones after failure of watchful waiting and medical expulsion therapy especially those without complications like obstruction. Keywords: Lower ureteric stone, extracorporeal shock wave lithotripsy

Highlights

Urinary calculi are the third most common from the ureteropelvic junction to the affliction of the urinary tract, exceeded only superior margin of the sacrum; the mid part, by urinary tract infections and pathologic from the upper to the lower edge of the conditions of the prostate[2]
A prospective study has been done on thirty-six patients, they were sequentially selected from referred cases to the ESWL department in Sulaimania Teaching Hospital in the period from June, 2010 to January, 2011
If we compare our study to a nearly similar study that which was done in the Sulaimania Teaching Hospital on ESWL in the treatment of ureteric stones in the year 2006, 24 patient included with lower ureteric stone and followed them for 6 months in which (58.3%) were free of stone, (29.2%) had residual stone and (12.5%) were failed after ESWL, and the factor that affects the rate of stone disintegration were the size of the stone, number of the sessions and number of shock waves[3,9]

Summary

Introduction

Urinary calculi are the third most common from the ureteropelvic junction to the affliction of the urinary tract, exceeded only superior margin of the sacrum; the mid part, by urinary tract infections and pathologic from the upper to the lower edge of the conditions of the prostate[2]. Most calculi sacroiliac joint; and the lower part, from the arise in the kidney when urine becomes lower edge of the sacrum to the supersaturated with a salt that is capable of vesicoureteral junction [4,5]. Objective: To assess the success rate of ESWL and tamsulosin in lower ureteral stone. To identify the parameters that affects the success rate of ESWL in the lower ureteral stone.

Objectives

Methods

Results

Discussion

Conclusion