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Al-Naemi RSM, Aldosky HYY, Shukri BSA. By-products of lithotripsy: Are they related to abdominal fat and wave characteristics? J Taibah Univ Med Sci 2019; 14:156-162. [PMID: 31435406 PMCID: PMC6694947 DOI: 10.1016/j.jtumed.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/28/2018] [Accepted: 01/05/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aimed to evaluate the correlations between by-products of extracorporeal shock wave lithotripsy (ESWL) and some physical parameters such as abdominal fat, energy levels, and shock wave pulses. Methods A total of 40 patients (20 men and 20 women), aged 37.18 ± 10.64 years, with renal or ureteral stones were recruited. All patients were treated with ESWL, and their abdominal fat was measured using an Omron body fat monitor and the body mass index (BMI). Parameters such as the levels of malondialdehyde (MDA), ketones, and protein in urine were measured before and after ESWL using a Bio Doctor Analyzer. The wave characteristics of the lithotripsy procedure and the wave pulses were determined. Results The mean levels of urinary MDA and ketones showed statistically significant increases in post-ESWL compared with pre-ESWL values. The results showed significant elevations in MDA and ketones in both male and female patients. In addition, there was a significant correlation between MDA/ketones and energy levels and between ketones and BMI in female patients. The analysis also revealed that the shock wave pulse had an insignificant impact on the by-product parameters. Conclusion An energy level of ≤4 J is recommended for overweight and obese patients undergoing ESWL. In addition, measurement of the post-ESWL MDA urinary level should be performed as a routine test, especially in obese male patients.
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Affiliation(s)
| | - Haval Y Y Aldosky
- Department of Physics, College of Science, University of Duhok, Iraq
| | - Bayan S A Shukri
- College of Medicine, University of Duhok, Kurdistan Region, Iraq
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Huang SW, Tsai CY, Wang J, Pu YS, Chen PC, Huang CY, Chien KL. Increased Risk of New-Onset Hypertension After Shock Wave Lithotripsy in Urolithiasis: A Nationwide Cohort Study. Hypertension 2017; 70:721-728. [PMID: 28827478 DOI: 10.1161/hypertensionaha.117.09669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/15/2017] [Accepted: 07/29/2017] [Indexed: 12/28/2022]
Abstract
Although shock wave lithotripsy is minimally invasive, earlier studies argued that it may increase patients' subsequent risk of hypertension and diabetes mellitus. This study evaluated the association between shock wave lithotripsy and new-onset hypertension or diabetes mellitus. The Taiwanese National Health Insurance Research Database was used to identify 20 219 patients aged 18 to 65 years who underwent the first stone surgical treatment (shock wave lithotripsy or ureterorenoscopic lithotripsy) between January 1999 and December 2011. A Cox proportional model was applied to evaluate associations. Time-varying Cox models were applied to evaluate the association between the number of shock wave lithotripsy sessions and the incidence of hypertension or diabetes mellitus. After a median follow-up of 74.9 and 82.6 months, 2028 and 688 patients developed hypertension in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups, respectively. Patients who underwent shock wave lithotripsy had a higher probability of developing hypertension than patients who underwent ureterorenoscopic lithotripsy, with a hazard ratio of 1.20 (95% confidence interval, 1.10-1.31) after adjusting for covariates. The risk increased as the number of shock wave lithotripsy sessions increased. However, the diabetes mellitus risk was similar in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups. Furthermore, the hazard ratio did not increase as the number of shock wave lithotripsy sessions increased. Shock wave lithotripsy consistently increased the incidence of hypertension on long-term follow-up. Therefore, alternatives to urolithiasis treatment (eg, endoscopic surgery or medical expulsion therapy) could avoid the hypertension risk. Furthermore, avoiding multiple sessions of shock wave lithotripsy could also evade the hypertension risk.
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Affiliation(s)
- Shi-Wei Huang
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Chung-You Tsai
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Jui Wang
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Yeong-Shiau Pu
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Pei-Chun Chen
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Chao-Yuan Huang
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.)
| | - Kuo-Liong Chien
- From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan University Hospital, Taipei City; Department of Public Health, China Medical University, Taichung, Taiwan (P.C.C.); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City (J.W., K.L.C.).
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D'Addessi A, Vittori M, Racioppi M, Pinto F, Sacco E, Bassi P. Complications of extracorporeal shock wave lithotripsy for urinary stones: to know and to manage them-a review. ScientificWorldJournal 2012; 2012:619820. [PMID: 22489195 PMCID: PMC3317539 DOI: 10.1100/2012/619820] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 12/05/2011] [Indexed: 01/11/2023] Open
Abstract
To identify the possible complications after extracorporeal shock wave lithotripsy (SWL) and to suggest how to manage them, the significant literature concerning SWL treatment and complications was analyzed and reviewed. Complications after SWL are mainly connected to the formation and passage of fragments, infections, the effects on renal and nonrenal tissues, and the effects on kidney function. Each of these complications can be prevented adopting appropriate measures, such as the respect of the contraindications and the recognition and the correction of concomitant diseases or infection, and using the SWL in the most efficient and safe way, tailoring the treatment to the single case. In conclusion, SWL is an efficient and relatively noninvasive treatment for urinary stones. However, as with any other type of therapy, some contraindications and potential complications do exist. The strictness in following the first could really limit the onset and danger of the appearance of others, which however must be fully known so that every possible preventive measure be implemented.
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Affiliation(s)
- Alessandro D'Addessi
- Department of Urology, Catholic University School of Medicine, Policlinico "A. Gemelli", Largo F. Vito, 00168 Rome, Italy.
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Wadhwa P, Aron M, Bal CS, Dhanpatty B, Gupta NP. Critical Prospective Appraisal of Renal Morphology and Function in Children Undergoing Shockwave Lithotripsy and Percutaneous Nephrolithotomy. J Endourol 2007; 21:961-6. [DOI: 10.1089/end.2006.9928] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pankaj Wadhwa
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Monish Aron
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandra Sekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - B. Dhanpatty
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Narmada P. Gupta
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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Abstract
INTRODUCTION Age has never been considered as a factor in the treatment of ureteral stones, but elderly male patients may suffer from concomitant illnesses that may affect SWL results, such as voiding difficulties and musculo-skeletal and cardio-vascular disorders. The aim of this study was to assess the success rate and complications of shock wave lithotripsy (SWL) for all size and location ureteral stones in patients older than 70 years of age. PATIENTS AND METHODS We retrospectively reviewed the charts and radiology films of all patients who had undergone SWL for ureteral stones with the HM3 lithotriptor and compared the results of patients younger than 70 years to those older than 70 years. RESULTS During 2000-2003, 238 consecutive male patients (23 older than 70 years) underwent SWL under regional anesthesia for all size and locations ureteral stones. Stone sizes, locations, opacity, and pre-operative drainage procedures matched in both groups. The overall stone-free rate was 91% for both groups. Complications were recorded in 1% of the older patients and 3.7% of the younger ones. No treatment-related mortality was recorded. CONCLUSIONS Age itself has no effect on the success rate of SWL with the HM3 lithotripter for ureteral stones. In general, SWL treatment showed a high success rate with minimal morbidity and no treatment-related mortality.
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Affiliation(s)
- Sarel Halachmi
- Department of Urology, Rambam Medical Centre, and Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel.
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Skolarikos A, Alivizatos G, de la Rosette J. Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol 2006; 50:981-90; discussion 990. [PMID: 16481097 DOI: 10.1016/j.eururo.2006.01.045] [Citation(s) in RCA: 185] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 01/30/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We review the pathophysiology and possible prevention measures of complications after extracorporeal shock wave lithotripsy (ESWL). METHODS A literature search was performed with the Medline database on ESWL between 1980 and 2004. RESULTS ESWL application has been intuitively connected to complications. These are related mostly to residual stone fragments, infections, and effects on tissues such as urinary, gastrointestinal, cardiovascular, genital, and reproductive systems. Recognition of ESWL limitations, use of alternative therapies, correction of pre-existing renal or systemic disease, treatment of urinary tract infection, use of prophylactic antibiotics, and improvement of ESWL efficacy are the most important measures of prevention. Decrease of shock wave number, rate and energy, use of two shock-wave tubes simultaneously, and delivery of two shock waves at carefully timed close intervals improve ESWL efficacy and safety. CONCLUSION ESWL is a safe method to treat stones when proper indications are followed. The need for well-designed prospective randomised trials on aetiology and prevention of its complications arises through the literature review.
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Affiliation(s)
- Andreas Skolarikos
- Urology Department, Athens Medical School, Sismanoglio Hospital, Athens, Greece
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