Abstract

The purpose of this study was to determine the indications and complications of intracorporeal lithotripsy in our institution. Retrospective study carried out at the urology unit of the 37 Military Hospital between 2012-2015. 42 patients had intracorporeal lithotripsy out of 359 patients who had surgery within the period. Records of all patients who had intracorporeal lithotripsy between December 2012 to December 2015 were collected and analysed. An endourology log sheet was used to record data of patient's name, age, sex, indication for operation, location of stone, intraoperative complications, type of instruments/materials used, stone analysis and follow-up dates. All patients between the ages of six months to seventy years presenting with urinary stones diseases within the period were included, whilst patients with urinary stone disease who were managed with open surgery were excluded.Ethical clearance was obtained from the 37 Military Hospital institutional review board. Lithotripsy constituted 42/359(11.7%) of the methods used in the surgical cases done within the period.The commonest age of presentation was between 31-40 years (26.2%), with a male to female ratio of 2:1. The commonest indications for lithotripsy were pain (92.8%) and hydronephrosis (61.9%). Ureteric stones are more common (50%), followed by renal stones (45%) with the commonest site being the proximal ureter. The commonest procedure was ureteroscopy. Ureteral mucosal injury (5/43) (11.62%), was the commonest intraoperative complication. Postoperative complications were reno-cutaneous fistula (1/43) (2.32%), severe bleeding (1/43) (2.32%) haematuria (4/43) (9.30%). Pain was the commonest indication for intra-corporeal lithotripsy (92.8%) and also the commonest post-operative complication (9.30%). None declared.

Highlights

  • Urinary stone disease is a serious health problem for a proportion of patients, in terms of incidence, recurrence rate and treatment cost in Ghana

  • Urolithiasis is a complex disease, an understanding of the epidemiology, and the interactions among different factors, may help lead to approaches that reduce the risk of stone formation.[1]

  • The commonest indication for lithotripsy was pain (92.8%) and hydronephrosis (61.9%) (Table 2)

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Summary

Introduction

Urinary stone disease is a serious health problem for a proportion of patients, in terms of incidence, recurrence rate and treatment cost in Ghana. Open surgery had been the main treatment modality in our environment despite the use of minimally invasive surgery in the industrialized countries for decades. Urolithiasis is a complex disease, an understanding of the epidemiology, and the interactions among different factors, may help lead to approaches that reduce the risk of stone formation.[1]. Urinary calculus is the third most common urologic disease after urinary tract infection and prostatic disease, with a lifetime prevalence of 10-15%.2. In the industrial countries the prevalence is 4–10%. In Germany the prevalence increased from 4.0 to 4.7% during the period 1980–2000.

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