Eswl; Extra Corporeal Shock Waves Lithotripsy With and Without Doublej-Ureteric Stent

Abstract

ABSTRACT… Objectives: Objectives of the study are to evaluate extracorporeal shock waves lithotripsy (ESWL) with and without double-J-ureteric stent in 2-3 cm renal stone. Study Design: Comparative study. Place and Duration of Study: This study was out conducted at Lithotripsy Center, Department of Urology & Renal Transplantation, KEMU/ Mayo Hospital, Lahore, from June 2015to May 2016."Methodology: This study consisted of 60 patients admitted. All patients were divided into two equal groups. Thirty patients of kidney stones were included in group A, who were treated by ESWL without double-j-ureteric stent. Group B, who were treated by ESWL with prior double-j-ureteric stent insertion. Detailed History was taken from all the patients with special regard to the renal stone pain. Detailed Clinical examination of the patient was done and recorded in proforma. Systemic review was also done to see any co-morbidity. All patients underwent for base line and specific investigations" like Urinalysis Pre-ESWL and at monthly intervals post ESWL, mid-stream urine examination for Gram's staining; culture and sensitivity were performed in selected patients, renal ultrasonography, Plain X-Ray KUB and intravenous Urography. Inclusion criteria were that all patients from both sexes between the ages of 15-45 years suffering from renal stones 2-3cm will be included in the study. In Exclusion criteria; patients are unfit for general anesthesia, advance cardiac diseases, bleeding disorders, pregnant women, lower ureteral stones, malignancy and severe urinary infection. Results: 60 patients, there were 40 males and 20 females, with male to female ratio of 2:1. Minimum of 15 year to 45 years in both group. Mean age was 32+ 2.1years. 38(63.33%) of patients has 2.5 -3 cm stone and 22(36.66%) patients has 2-2.5cm stone. Commonest location of stone was 34(57%) cases were lying in calyces followed by pelvis stones which accounted for 26(43%) stones. The average number of retreatment sessions was 2 to 3 sessions, ranged 1 to 5 sessions. The majority 39 (65%) patients needed one & two sessions. Three & four sessions were used in 17 (28.33%) and in five session 04(06%) cases needed. Stone clearance observed 5 to 45days in 2 to 2.5 cm stone. Means clearance were seen 35+4.6 days in without Double-J-Ureteric Stent while 29+3.8 days in with Double-J-Ureteric Stent. Conclusion: In conclusion our study revealed that The extra corporeal shock waves lithotripsy with double-j-ureteric stent is safe, effective and with less complication rate then without double-j-ureteric stent. Key words:Double-J-Ureteric Stent, Urolithiasis, extracorporeal shock waves lithotripsy (ESWL).