Abstract
Background: Extracorporeal shock wave lithotripsy (ESWL) became the first line in the treatment of ureteric stone after failure of conservative treatment because of its safety, simplicity and effectiveness. It is not invasive procedure and can be done on outpatient basis without anesthesia and with few complications which is most probably temporary and treatable. The objective of this study is to evaluate the efficiency and safety of ESWL in treatment of ureteric stone in Iraq. Materials and Methods: A total of 112 Iraqi patients with ureteric stones were participated in this prospective observational study in which patients scheduled for ESWL treatment for a period of 6 months. Patients were divided into 2 groups: 1) Group 1: 52 patients with proximal ureteric stone; 2) Group 2: including 60 patients with distal ureteric stone. Preoperatively all patient underwent bowel preparation and were asked to fast for 8 hours before the procedure. Results: The age ranged between 22 and 55 with mean of 42 (SD = 5) years. Around 46% had proximal ureteric stone and the rest were in distal ureter. Around 44% needed one session and 40% needed two sessions to be stone-free respectively. In regards to associated symptoms, 74% had ureteric colic, 3% haematuria, 43% microhematuria and 12% UTI. Mild hydronephrosis was found in 90% of the cases and 30 reported had previous intervention. Success rate was 90%. Conclusions: ESWL is safe and effective in treatment of ureteric stone with few complications and must be regarded first choice after conservative treatment in a patient with uncomplicated ureteric stone.
Highlights
Since its introduction in the 1980 [1], extracorporeal shock wave lithotripsy (ESWL) has become the standard convenient, non-invasive outpatient procedure used for treatment of renal and ureteric stones and since the management of nephrolithiasis has undergone a complete revolution [1]
After ESWL introduction in 1980s, the technological developments have resulted in more advanced lithotripters with shorter focal length and narrower focal breadth, which help reduce the level of pain and obviate the need for anaesthesia and hospital admission for the procedure [3]
Around 46% had proximal ureteric stone and rest were in distal ureter
Summary
Since its introduction in the 1980 [1], extracorporeal shock wave lithotripsy (ESWL) has become the standard convenient, non-invasive outpatient procedure used for treatment of renal and ureteric stones and since the management of nephrolithiasis has undergone a complete revolution [1]. In addition to that, according to recommendation of American Urological Association Stone Guidelines Panel in 1997, ESWL is still the first line method of treatment for ureteral and renal stones of size smaller than 2 cm [4]-[6]. Extracorporeal shock wave lithotripsy (ESWL) became the first line in the treatment of ureteric stone after failure of conservative treatment because of its safety, simplicity and effectiveness. It is not invasive procedure and can be done on outpatient basis without anesthesia and with few complications which is most probably temporary and treatable. Conclusions: ESWL is safe and effective in treatment of ureteric stone with few complications and must be regarded first choice after conservative treatment in a patient with uncomplicated ureteric stone
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