Abstract
Objectives:To appraise the effects of previous history of ineffectual extracorporeal shockwave lithotripsy (SWL) treatment on the execution and end result of percutaneous nephrolithotomy (PCNL).Methods:The study was performed from January 2012 till November 2019 at the urology department at our hospital, a tertiary healthcare center. In total, four hundred and twenty two patients were enrolled in the study. We arranged the study participants into two groups. Group-I comprised of 66 subjects who had undergone failed SWL 12 months prior to PCNL procedure, while Group-II included patients who had no history of previous SWL. Information related to study variables was registered in designated proformas and then processed in SPSS version 16 for the statistical computations.Results:On the whole, the mean age of patients was 45.25± 14.38 years. While the mean calculus size was 494.80±128.83 mm2. The complexity of stones formulated on the basis of Guy’s stone score was identical among the two groups. American Society of Anesthesiologists (ASA) class categories were almost similar among the two groups. Stone free rates of 80.30% and 81.74% (p value=0.73) were observed in Group-I and II respectively. Time to create PCNL tract and mean drop in hemoglobin were noted to be significantly higher in Group-I. Complication rates and grades were not being dissimilar among the two groups.Conclusion:Patients having prior history of unsuccessful SWL history before undertaking the PCNL procedure manifested similar stone free rates and complications rates as those observed in SWL naive cases of PCNL.
Highlights
ESWL is benchmark treatment for smaller renal stones
Total of 66 patients were kept in Group-I that comprised of subjects having previous history of failed shock wave lithotripsy (SWL)
356 patients in Group-II were those who had no previous history of shockwave lithotripsy (SWL)
Summary
ESWL is benchmark treatment for smaller renal stones (size below 2 cm). While PCNL is employed for larger calculi (complex and size more than 2 cm).[1-4]. The average cost of ESWL per treatment has made the procedure very much affordable to people with moderate income.[4-6]. This led to misuse of SWL in last few years especially in less developed regions and non academic hospitals. As indicated by the recent researches, some factors lead to lower stone free rates in patients having longer skin to stone distance, higher BMI, stone Hounsfield units and lower pole location.
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