Identifying risk factors in developmentof clinically significant post-shock-wave lithotripsy subcapsular hematomas

Newman, L.H.; Saltzman, Brian

doi:10.1016/0090-4295(91)80009-v

Cited by 58 publications

(40 citation statements)

References 10 publications

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“…15,16 Although a retrospective series of 5 (0.49%) patients with symptomatic peri-renal hematomas found that all 5 patients were hypertensive, 3 had diabetes mellitus, and 2 had coronary artery disease, these risk factors have not been consistently demonstrated with the exception of uncontrolled hypertension. 13,17 Recently, an ultrasound examination of all patients post-SWL with the electromagnetic Storz Modulith SLX lithotripter (Storz, St. Louis, MO) found the incidence of asymptomatic peri-renal hematomas to be 4.1%, while the incidence of symptomatic peri-renal hematomas was similar to other lithotripters at a rate of 0.7%. 18 Furthermore, the probability of hematoma increased 1.67 times for every 10-year increase in patient age.…”

Section: Resultsmentioning

confidence: 99%

Shock wave lithotripsy in patients requiring anticoagulation or

Alsaikhan

Andonian

2011

CUAJ

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Extracorporeal shockwave lithotripsy (SWL) remains the only truly minimally invasive procedure for the treatment of upper tract nephrolithiasis. Recently, there has been a recent rise in the patients on antiplatelet agents. Therefore, the aim of the present study is to review the literature available regarding SWL in these high-risk patients requiring anti-coagulation therapy. Alternative therapies to SWL are also presented. RésuméLa lithotripsie extracorporelle par ondes de choc (LECOC) demeure la seule intervention qui soit réellement minimalement invasive pour le traitement de la néphrolithiase dans les voies urinaires supéri-eures. Récemment, on a noté une hausse du nombre de patients traités par antiplaquettaires. Par conséquent, le but de la présente étude est d'examiner les articles publiés sur la LECOC chez ces patients à risque élevé ayant besoin d'un traitement anticoagulant. On présente également des traitements de rechange à la LECOC.

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Section: Resultsmentioning

confidence: 99%

Shock wave lithotripsy in patients requiring anticoagulation or

Alsaikhan

Andonian

2011

CUAJ

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“…El hematoma renal tras litotricia extracorpórea es una complicación infrecuente, aunque tal vez la más grave, los principales factores de riesgo son la hipertensión y alteraciones de la coagulación primarios o secundarios al tratamiento antiagregante. También influye el número de ondas de choque y la energía de estas 3 . Se manifiesta principalmente como dolor en el flanco y el tratamiento de elección suele ser conservador.…”

Section: Discussionunclassified

“…El tratamiento habitual es el reposo y reposición sanguínea si precisa 2 . Esta complicación se asocia a la presencia de hipertensión arterial o alteraciones de la coagulación en el paciente, también se relaciona con el número de ondas, así como al empleo de alta energía en las mismas durante el tratamiento 3 . Su diagnóstico suele ser clínico, con presentación del dolor constante en el flanco que cede mal al tratamiento, no suele ser un dolor tan fuerte como en los cólicos pero si muy persistente e invalidante y sin justificación 4 .…”

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Hematoma escrotal como primera manifestación de hematoma retroperitoneal tras litotricia extracorpórea

Vega¹,

Toral²,

Lamelas³

2008

Actas Urol Esp

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Describimos el caso de un paciente que a las 15 horas del tratamiento y fragmentación de una litiasis en el uréter proximal mediante litotricia extracorpórea presenta un hematoma escrotal indoloro como única manifestación de hematoma subcapsular.Palabras Clave: Hematoma retroperitoneal. Litotricia. Hematoma escrotal. ABSTRACT SCROTAL HAEMATOMA AS A SIGN OF RENAL HEMATOMA AFTER ESWLWe described the case of a patient who presented a large scrotal black discoloration 15 hours after successful extracorporeal lithotripsy of a proximal ureteral calculus. The patient did not present any other clinical symptoms as a sign of subcapsular haematoma.

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“…Because SW injury is dominated by vascular trauma it is not surprising that patients with clotting disorders experience greater damage 85 . A bleeding diathesis can significantly lower the threshold for severe injury, and there is a report of uncontrolled renal hemorrhage in a patient who received only 250 SW's 86 .…”

Section: Factors That Affect the Severity Of Swl Injurymentioning

confidence: 99%

The Acute and Long-Term Adverse Effects of Shock Wave Lithotripsy

McAteer

Evan

2008

Seminars in Nephrology

152

105

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Shock wave lithotripsy (SWL) has proven to be a highly effective treatment for the removal of kidney stones. Shock waves (SW's) can be used to break most stone types, and because lithotripsy is the only non-invasive treatment for urinary stones SWL is particularly attractive. On the downside SWL can cause vascular trauma to the kidney and surrounding organs. This acute SW damage can be severe, can lead to scarring with a permanent loss of functional renal volume, and has been linked to potentially serious long-term adverse effects. A recent retrospective study linking lithotripsy to the development of diabetes mellitus has further focused attention on the possibility that SWL may lead to life-altering chronic effects 1 . Thus, it appears that what was once considered to be an entirely safe means to eliminate renal stones can elicit potentially severe unintended consequences. The purpose of this review is to put these findings in perspective. The goal is to explain the factors that influence the severity of SWL injury, update current understanding of the long-term consequences of SW damage, describe the physical mechanisms thought to cause SWL injury, and introduce treatment protocols to improve stone breakage and reduce tissue damage. Keywordslithotripsy; shock waves; urinary stones; kidney; injury; vascular trauma The Advantages and Limitations of SWLShock wave lithotripsy employs high energy acoustic pulses (shock waves) generated outside the body to break stones within the kidney and ureter. As such SWL is the only non-invasive method available to remove stones. In the early years following its introduction SWL was considered an option for the treatment of virtually any stone type in any anatomical location. Urologists soon learned, however, that the urinary tract has a limited ability to clear stone fragments and that ureteral obstruction could occur if the mass of stone debris was too high. As such SWL is now used to treat otherwise uncomplicated solitary stones, or a combined stone burden of less than 2 cm (on KUB), located in the upper urinary tract (renal pelvis or proximal ureter) 2 . Not all mineral types respond well to SW's. Some calcium oxalate monohydrate stones, brushite stones and a sub-type of cystine can be highly SW-resistant 3. A noteworthy drawback of SWL is that in many cases stone fragments left behind can serve as foci for the development of new stones 4. As such, stone free rates are lower and stone Please address correspondence to: James A. McAteer, Ph.D., Professor, Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, mcateer@anatomy.iupui.edu, (FAX) 317-278-2040. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process ...

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Identifying risk factors in developmentof clinically significant post-shock-wave lithotripsy subcapsular hematomas

Cited by 58 publications

References 10 publications

Shock wave lithotripsy in patients requiring anticoagulation or

Shock wave lithotripsy in patients requiring anticoagulation or

Hematoma escrotal como primera manifestación de hematoma retroperitoneal tras litotricia extracorpórea

The Acute and Long-Term Adverse Effects of Shock Wave Lithotripsy

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