ESWL;

EXTRA CORPOREAL SHOCK WAVES LITHOTRIPSY WITH AND WITHOUT DOUBLEJ- URETERIC STENT

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.