A DESCRIPTIVE STUDY OF MORBIDITY PROFILE AFTER ESWL FOR UROLITHIASIS

Sonam Deki, Amit Agrawal

Abstract


Background: Urinarolithiasis is a common disease of urinary tract after urinary tract infection (UTI) and prostate diseases and its incidence is
increasing. Treatment of urolithiasis includes ureteroscopic endoluminal extraction of stones (URS), extracorporeal shockwave lithotripsy
(ESWL) and percutaneous nephrolithotripsy (PCNL). ESWL may sound appealing because of it's a non invasive procedure but it is not bereft of
renal and extrarenal complications. All the studies on complications following ESWL are not on Indian population and the data on this subgroup of
population who are at maximum risk of urolithiasis is missing. Thus, this study aims to provide data on the subject on Indian population.
Method: This is a descriptive observational study carried out between July 2017 and July 2019, on 180 consecutive patients who underwent
ESWL.
Result: Out of 180 patients 161 (89.44%) patients were male and 19(10.56%) patients were female. Male to female ratio was 8.47: 1. Mean age of
the patients of this study group was 34.79 yrs. Out of 180 patients, 171 (95%) had pain of various grades. Only 9 patients (5%) did not complain of
pain. The second most common presenting complain was hematuria 17(9.44%). There was no statistical significance between presenting symptom
of hematuria and the size of stone with P value of 0.566. microscopic hematuria was present in 17 patients (5.56%). The mean size of the stone was
11.09mm and majority of patients had stones in size range of 09 mm to 12 mm. Out of 180 patients 64 patients (35.55%) had stones in upper pole of
the kidney followed by 41 patients (22.78%) upper ureter and 35 patients (19.44%) lower pole. The most common complication was Graveluria in
93 patients. 96(53.33%) patients who underwent ESWL had successful clearance of stone at first session. 84(46.66%) patients had to undergo 2nd
and 3rd sessions of ESWL.
Conclusion: Stone free rate is 77.22 % after completion of ESWL. Failure rate was seen in 12.22 % of patients. Graveluria, Loin pain, hematuria,
and Steinstrasse are the complications following. Nil effect was seen in 21 patients corresponding to 11.67% of the patients. ESWL is safe and
effective for renal and upper ureteric stones. Stone size was directly proportional to the number of ESWL sittings.


Keywords


ESWL, RIRS, SFR, PCNL

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