Lithotripsie extracorporelle et obésité avec un IMC supérieur à 35

Abstract

The treatment of urinary stones in morbidly obese patients is associated with higher morbidity. Extra corporeal shock wave lithotripsy (ESWL) is one of the options to achieve urinary stone clearance with minimal morbidity of these patients. The purpose of this study was to evaluate the outcomes and efficiency of ESWL in patients with body mass index (BMI) upper 35 Kg/m(2). We retrospectively reviewed the records of 98 patients with BMI more than 35 and urinary stones who were treated using ESWL from October 2002 to January 2008. Evaluation of efficiency was based on radiological examinations using abdominal radiography, echography or CT scan. It was mode during as consultation with the urologist surgeon four or six weeks after the last session. Ninety-eight patients, 53 men and 45 women, mean BMI 37.74 presented 133 urinary stones of mean size 10.38 mm. Their location was 83% renal, with 42.11% low caliceal. The number of ESWL is 219, without analgesics safe three under neuroleptanalgesics. Fifty-four cystoscopics stents have been pose (40.6%). The overall stone free was 56.3%, residual fragment of 37.5% and failure of 6.2%. The efficiency was bound to the BMI in a significant way. For the complications: five renal colics, three obstructive pyelonephritis with cystosccopic stent. We conclude that ESWL is an effective and mini invasive treatment, which can be proposed, in the first intention in the treatment of urinary stones to obese patients.