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Gitonga EN, Shen H. Small bowel obstruction and strangulation secondary to an adhesive internal hernia post ESWL for right ureteral calculi: a case report and review of literature. BMC Gastroenterol 2021; 21:176. [PMID: 33865311 PMCID: PMC8052854 DOI: 10.1186/s12876-021-01760-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background Extracorporeal shock wave lithotripsy (ESWL) is a relatively safe and convenient mode of treatment for ureteral and renal stones, despite its relative safety; ESWL is not without its complications. We present a case of a patient we managed for small bowel obstruction and strangulation due to an adhesive internal hernia after ESWL was done because of right ureteral calculi. Case presentation We report a case of a 59-year-old patient who presented with severe abdominal pain a few hours after ESWL because of a right upper ureteric calculus. The abdominal pain increased in severity in time and became more generalized. The patient had one episode of gross hematochezia as she was being prepped for emergency laparotomy. Intra-op, she had a strangulated internal hernia because of an omental-mesenteric adhesion. Conclusion This case report hopes to highlight the potential of complications like acquired IH due to adhesions in patients with a history of ureteral calculi, and also the complications that may come about post-ESWL. Patients who present with signs of persistent abdominal pain post-ESWL should be vigilantly observed. If symptoms persist, increase in intensity or there is a general deterioration of the patients’ hemodynamic status, even in light of negative MDCT findings, prompt surgical intervention is crucial for definitive diagnosis as well as management.
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Affiliation(s)
- Elaine N Gitonga
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Haitao Shen
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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Ng DM, Haleem M, Mamuchashvili A, Wang KY, Pan JF, Cheng Y, Ma Q. Medical evaluation and pharmacotherapeutical strategies in management of urolithiasis. Ther Adv Urol 2021; 13:1756287221993300. [PMID: 33708261 PMCID: PMC7907714 DOI: 10.1177/1756287221993300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Treatment of urolithiasis depends on several important factors which include stone location, size, composition, and patient symptoms. Although significant advancements have been made in the surgical management of urolithiasis in the last decade, pharmacotherapy which can prevent the formation of new stones and decrease the recurrence of urolithiasis has not experienced the same level of success. Currently, urolithiasis is regarded as a complicated syndrome that is determined by numerous factors, and any treatment plan for urolithiasis should be individualized while considering any potential damage arising from stone-forming factors. This review introduces the most popular methods currently used to evaluate urolithiasis and the pharmacotherapy of urolithiasis based on patient-specific factors.
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Affiliation(s)
- Derry Minyao Ng
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Maria Haleem
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Anny Mamuchashvili
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Kai-yun Wang
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Jin-Feng Pan
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yue Cheng
- Department of Urology, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315010, China
| | - Qi Ma
- Translational Research Laboratory for Urology, The Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, 315010, China
- Department of Urology, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, 315010, China
- Comprehensive Urogenital Cancer Center, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, 59, Liuting Street, Ningbo, Zhejiang 315010, China
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Abstract
PURPOSE OF REVIEW The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption. RECENT FINDINGS Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of need. Face-to-face contact is largely minimized and innovative, virtual communication methods are used in the outpatient setting and multidisciplinary team meetings. Surgical practice is changing because of the risks posed by COVID-19 and procedures can be prioritized in a nonurgent, low priority, high priority or emergency category. SUMMARY Although the COVID-19 pandemic will inevitably affect urological services, steps can be taken to mitigate the impact and prioritize the patients most in need of urgent care. Similarly, in future; simulation, e-learning and webinars will allow interaction to share, discuss and debate focused training and education.
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Affiliation(s)
- Thomas Hughes
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hui Ching Ho
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shahrokh Francois Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, New York
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Bhaskar Kumar Somani
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton, Southampton, UK
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Scotland KB, Safaee Ardekani G, Chan JYH, Paterson RF, Chew BH. Total Surface Area Influences Stone Free Outcomes in Shock Wave Lithotripsy for Distal Ureteral Calculi. J Endourol 2019; 33:661-666. [PMID: 30860394 DOI: 10.1089/end.2019.0120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Current American Urological Association guidelines recommend ureteroscopy (URS) as primary management of distal ureteral stones and shock wave lithotripsy (SWL) as a secondary option. Utilization of SWL in the management of nephrolithiasis in North America has decreased. We hypothesized that SWL continues to be an effective option in the management of distal ureteral calculi and studied data from our center in patients who received SWL for distal ureteral stones. Methods: A retrospective review was performed of 104 patients treated initially with SWL for distal ureteral calculi between 2011 and 2018 at this institution. The success rate of SWL was assessed through radiologic imaging and if subsequent procedures were required to render patients stone free. Results: Operative note and chart review identified 104 patients who presented with distal ureteral stones and were treated with SWL as the initial form of management. Average patient age was 52.2 ± 15.3 years, average BMI was 27.4 ± 5.7, and average total axial stone surface area was 25.96 ± 14.32 mm2. Of these patients, 78.8% (n = 82) were stone free following one SWL and required no subsequent procedures. Of these patients, 87.5% (n = 91) were stone free following a second SWL, and 87.5% (n = 91) were stone free following a secondary URS. After the initial SWL, residual stones were identified in 21.2% of patients (n = 22). Four patients, 3.8%, required a salvage URS following a failed second SWL to achieve stone-free status. Conclusion: One SWL procedure offers a stone-free rate (SFR) of 78.8% and after two SWLs an 87.5% SFR. Only 12.5% of patients undergoing SWL at our center required URS to achieve a stone-free status. SWL is an effective modality in the treatment of distal ureteral stones.
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Affiliation(s)
- Kymora B Scotland
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Justin Y H Chan
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Ryan F Paterson
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Ben H Chew
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Kiaei MM, Mohaghegh MR, Movaseghi G, Ghorbanlo M. Enteral diclofenac controls pain and reduces intravenous injection during extracorporeal shock wave lithotripsy. Eur J Transl Myol 2018; 28:7353. [PMID: 29991983 PMCID: PMC6036311 DOI: 10.4081/ejtm.2018.7353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/22/2018] [Accepted: 02/24/2018] [Indexed: 11/23/2022] Open
Abstract
Urinary system stones are the third most common disease of urinary system following urinary infection and prostate pathology. Extracorporeal shockwave lithotripsy (ESWL) is one of the methods used to treat Urolithiasis where shockwaves are transmitted through skin and body organs and crush the stones into small pieces. This is a painful procedure which usually requires analgesics. Each analgesic drug has its own advantages and disadvantages. The present research seeks to study the effectiveness of using diclofenac suppository in order to control pain and reduce need for venous drugs during ESWL procedure. This is a double blind clinical trial. 158 patients resorting to Shahid Hasheminezhad Specialized Center for ESWL were randomly selected to take part in this projects with due consideration of inclusion criteria. The patients were equally divided into the S (diclofenac suppository) and A (placebo) groups. 2 diclofenac suppositories were used in the S group 20 minutes prior to beginning ESWL. Then, ESWL was carried out in supine position using fluoroscopic conduction with standard method. The present research has studied pain scale of patients, operator’s and patient’s satisfaction during the operation and patient’s hemodynamic parameters in three phases prior to, during, and after ESWL. SPSS v.17 was used to study the data and Chi-Square Tests and Repeated Measure ANOVA were used to analyze the results. The level of significance in the present research was set to P-value < 0.05.A review of pain scales across both groups showed that using diclofenac suppository has a significant influence in reducing the pain scale and, hence, need for venous drugs (P-value < 0.05). No significant difference was observed between the two groups in terms of heart beat and blood pressure changes in various times (P-value > 0.05). The results also report different satisfaction levels for patients and operators across the two groups (diclofenac suppository and placebo) (P-value < 0.05). Higher satisfaction levels were observed among both patients and operators in the group receiving diclofenac suppository. A general look at the data yields the conclusion that receiving pain killers (diclofenac suppository) before starting ESWL plays a more efficient role in reducing pain scales of patients and enhancing operators’ satisfaction..
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Affiliation(s)
- Mehrdad Mesbah Kiaei
- Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Reza Mohaghegh
- Department of Anesthesia and Critical Care, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Movaseghi
- Department of Anesthesia and Critical Care, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ghorbanlo
- Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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AbdelGawad EA, AbdelGawad EA, Magdi M. Reliability of ADC values in recognition of renal changes produced by extracorporeal shock wave lithotripsy (ESWL). THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Waqas M, Saqib IUD, Imran Jamil M, Ayaz Khan M, Akhter S. Evaluating the importance of different computed tomography scan-based factors in predicting the outcome of extracorporeal shock wave lithotripsy for renal stones. Investig Clin Urol 2017; 59:25-31. [PMID: 29333511 PMCID: PMC5754579 DOI: 10.4111/icu.2018.59.1.25] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/17/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose To evaluate the impact of various computed tomography scan-based parameters of renal stones on the outcome of extracorporeal shock wave lithotripsy (ESWL). Materials and Methods We conducted a retrospective study of patients who underwent ESWL for renal stones (sized 5–20 mm) from January 2013 to December 2016. We evaluated body mass index, location of the stone, skin-to-stone distance (SSD), stone attenuation value (SAV), stone diameter, Hounsfield density, stone area, and stone volume. Statistical analysis was done and significance was confirmed by multivariate logistic regression analysis. Results Of the 203 patients 122 (60.1%) had successful clearance of the stone. The presence of a double J stenting, a lower pole location, a higher SAV, higher Hounsfield density, larger stone area, larger stone diameter, and higher stone volume were negative predictors of ESWL outcome. When these parameters were analyzed with multivariate logistic regression analysis, stone location, SSD, and SAV were the only significant independent predictors of the outcome of ESWL. Conclusions Stone location, SSD, and SAV are reliable and strong predictors of ESWL outcome for the treatment of renal stones.
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Affiliation(s)
- Muhammad Waqas
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | - Imad-Ud-Din Saqib
- Foundation Year Resident, Shifa International Hospital, Islamabad, Pakistan
| | | | - Mohammad Ayaz Khan
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | - Saeed Akhter
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
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How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for < 15 mm upper urinary stones: a prospective multi-center randomized controlled trial about external physical vibration lithecbole (EPVL). World J Urol 2017; 36:293-298. [PMID: 29197021 DOI: 10.1007/s00345-017-2123-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/02/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To asset the efficacy and safety of EPVL plus ESWL compared with ESWL alone for the treatment of simple upper urinary stones (< 15 mm). MATERIALS AND METHODS All patients with upper urinary stones (< 15 mm) were prospectively randomized into two groups. In treatment group, patients were assigned to immediate EPVL after ESWL, while in control group, ESWL alone was offered. All patients were reexamined at 1, 2, and 4 weeks after ESWL. Stone size, stone location, stone-free rate (SFR), and complication rate were compared. RESULTS 56 males and 20 females in treatment group were compared to 52 male and 25 females in control group (p = 0.404). Median ages were 42.9 ± 1.5 years in treatment group and 42.7 ± 1.3 years in control group (p = 0.943). Median stone size was 10.0 ± 0.4 mm (3-15 mm) in treatment group and 10.4 ± 0.4 mm (4-15 mm) in control group (p = 0.622). The stone clearance rate in treatment and control group at 1 week after ESWL was 51.3% (39/76) and 45.4% (35/77) (p > 0.05), at 2 weeks was 81.6% (62/76) and 64.9% (50/77) (p < 0.05), and at 4 weeks was 90.8% (69/76) and 75.3% (58/77) (p < 0.05), respectively. CONCLUSIONS EPVL is a noninvasive, effective, and safe adjunctive treatment which increases and accelerates upper urinary stones discharge after ESWL treatment.
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Waqas M, Ayaz Khan M, Waqas Iqbal M, Akbar MK, Saqib IUD, Akhter S. Non-Contrast Computed Tomography Scan Based Parameters of Ureteric Stones Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy. Cureus 2017; 9:e1227. [PMID: 28589076 PMCID: PMC5459557 DOI: 10.7759/cureus.1227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective To compare the non-contrast computed tomography (NCCT) scan-based parameters of ureteric stones affecting the outcome of extracorporeal shock wave lithotripsy (ESWL). Materials and methods We retrospectively evaluated the pre-procedure NCCT of 74 patients who had ESWL for solitary ureteric calculi of 5-20 mm in diameter. We assessed the age, sex, basal metabolic index (BMI), laterality, location, presence of double 'J' (DJ) stent, skin to stone distance (SSD), stone maximum diameter, Hounsfield unit (HU), Hounsfield density (HD), area, and volume. All those who had no stone on follow-up imaging within 30 days were declared successful while those who had residual stone were declared failures. Results The overall success rate was 78% (58/74). Sixty (81.1%) patients were male. The success of ESWL was correlated with lower SSD, Hounsfield units (HU) and Hounsfield density (HD). However, in multivariate analysis, SSD, Hounsfield unit, and stone area showed correlation with success of procedure but Hounsfield density failed to show correlation. The success rate in patients with stone HU <500, 500-1000 and >1000 were 93.9%, 69%, and 58.3%, respectively. Patients with lower BMI (<30 kg/m2) and HD (<76 HU/mm) were more prone towards success of the procedure than those with higher BMI (>30 kg/m2) and higher HD (>76 HU/mm). Conclusion BMI, SSD, stone Hounsfield units and Hounsfield unit density were strong predictors of outcome of ESWL for ureteric stone.
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Affiliation(s)
- Muhammad Waqas
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | - Mohammad Ayaz Khan
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | | | - Mian Khalid Akbar
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | - Imad-Ud-Din Saqib
- Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan
| | - Saeed Akhter
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
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Noviandrini E, Birowo P, Rasyid N. Urinary stone characteristics of patients treated with extracorporeal shock wave lithotripsy in Cipto Mangunkusumo Hospital Jakarta, 2008–2014: a gender analysis. MEDICAL JOURNAL OF INDONESIA 2015. [DOI: 10.13181/mji.v24i4.1258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: The incidence of urinary stone patient in Indonesia has increased every year in both genders. Data showed that urolithiasis was higher in male rather than female. The aimed of this study was to describe the characteristics of urinary stone found in patient who underwent extracorporeal shock wave lithotripsy (ESWL) at Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. Methods: Data obtained from ESWL medical record Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. We obtained 5,174 out of 6,020 data due to incompleteness data record. We sorted data records by gender, age, stone location, stone opacity, size of the stone, and history of ESWL, and analyzed by statistic tools (SPSS v 20 for Mac).Results: From 5,174 records, we found that the incidence of urinary stones was two times higher in male rather than female (66.3%:33.64%), occurred mostly in productive age (65.2% male, 65.9% female). Unilateral kidney stone was most common location found for both gender (50.2% male, 57.2% female), and most frequent site located in calyx inferior (24.8% male, 28.9% female). About 72.9% stone was radiopaque (73.7% male and 71.5% female). The mean size of the stone in male and female was 11.34±7.15 mm and 11.90±7.54 mm, respectively. This study also showed that 79.3% patients came for first ESWL.Conclusion: Urinary stone founds two times higher in male than female, and mostly occurs on their productive ages. Unilateral kidney stone in calyx inferior become the most common stone found in both gender. Most of the stone has radiopaque opacity.
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Prstojevic JK, Junuzovic D, Hasanbegovic M, Lepara Z, Selimovic M. Characteristics of calculi in the urinary tract. Mater Sociomed 2015; 26:297-302. [PMID: 25568625 PMCID: PMC4272831 DOI: 10.5455/msm.2014.26.297-302] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/18/2014] [Indexed: 11/15/2022] Open
Abstract
Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (χ2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter.
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Affiliation(s)
| | | | - Munira Hasanbegovic
- Urology clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina
| | - Zahid Lepara
- Urology clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina
| | - Mirsad Selimovic
- Urology clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina
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