Abstract
Place of Study: American Kidney Stone Centre (AKSC), Bahawalpur, a private setup.Duration of Study: January 2005 to June 2007.Design of Study: Prospective, Observational.Material & Methods: A total of 250 patients were evaluated for ESWL results. The one session comprised of 1500-2500shocks with intermittent fluoroscopy with X-Ray focusing. A period of 7 – 10 days was given between two sessions. Theprocedure was repeated till the clearance of stone no matter what was the number of sessions. The complications like pain,colic, hematuria were addressed adequately and immediately. The development of steinstrasse was initially observed and fewrequired manipulation. The stone size is the only matter of concern in few patients especially lower pole stones.Results: The stone clearance was achieved in 89% of patients. Auxillary procedures were required in 10.8% before ESWLand 9.6% of patients after ESWL. Which include Endoscopic stenting and manipulation with uretero-renoscopy andintracorporeal lithotripsy. Prophylactic insertion of DJ stenting reduced complication rate and incidence of steinstrasse.Conclusion: ESWL can be safely recommended for patients of urolithiasis irrespective of age and stone size with promisingresults of stone clearance and patient acceptance.Key Words: ESWL-Extracorporeal shock wave lithotripsy, URS-Ureterorenoscopy. ICL-Intracorporeal lithotripsy.
Highlights
Since the advent of Extracorporeal Shock Wave Lithotripsy in 1980s, the improvements in mechanics of lithotripters and better understanding of shock wave physics has made this mode of stone treatment, acceptable and more effective
ESWL can be safely recommended for patients of urolithiasis irrespective of age and stone size with promising results of stone clearance and patient acceptance
The single renal unit treatment strategy was exercised during ESWL in this setup, bilateral renal stones were treated as separate units
Summary
Since the advent of Extracorporeal Shock Wave Lithotripsy in 1980s, the improvements in mechanics of lithotripters and better understanding of shock wave physics has made this mode of stone treatment, acceptable and more effective. Many years after the first application, ESWL has gained world wide acceptance as first choice therapy for most of urolithiasis. Increasing experience show some advantages, cost reduction, permanent monitoring, lack of exposure to ionizing radiation in ultrasound monitoring. Follow-up of stone patients after ESWL is mandatory and ultimate goal for treating stones by whatever means is to get the patients stone free and prevent recurrence[1].Over the last two decades there has been gradual increase in utilization of ESWL due to patient desire[2]
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