EFFECTIVENESS AND SAFETY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR UNCOMPLICATED PELVIC CONCREMENTS
https://doi.org/10.21886/2308-6424-2017-5-3-39-48
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Abstract
Introduction. Extracorporeal shockwave lithotripsy (ESWL) allowed to improve the treatment results for patients suffering from the kidney stone disease (KSD), decrease the number of complications, optimize the nearest and distant therapy results; however, its success depends on the initial size and shape of the stone. Purpose of the study. Тo examine the clinical effectiveness and safety of electromagnetic ESWL used on simple renal calculi taking their sizes into account. Materials and methods. The survey included 110 patients with simple renal calculi who passed electromagnetic ESWL procedures. The first group consisted of 75 patients with calculi ≤ 15 mm in diameter, the second group included 35 patients with stones > 15 mm. Results. Complete disintegration of stones ≤ 15 mm was accomplished in 74,7% of cases in 1-2 lithotripsy sessions, and after 3 months residual fragments were found in 4% of cases only. Elimination of stones > 15 mm from the renal collecting system takes considerably longer, all patients require more than 1 lithotripsy session. In 3 months following the ESWL residual stones were found in 17,2% of analysed cases. Stone sizes had no bearing on the pain syndrome frequency and severity as well as activation of urinary infection. Macrohematuria, renal haematomas, and an increase of blood creatinine level compared with the original value were more frequent in patients with stones > 15 mm. Conclusions. Electromagnetic ESWL is an efficient and safe method for monotherapy of patients with uncomplicated pelvic concrements. Clinical ESWL effectiveness for stones ≤15 mm by the 3rd month of monitoring reaches 96,0%, for stones > 15 mm it is 82,8% (р<0,05). The level and severity of complications is higher in case of pelvic stones >15 mm compared with the stones < 15 mm in diameter (р<0,05).
About the Authors
A. V. KhasigovRussian Federation
Alan Vladimirovich Khasigov, MD, Head of the Radiology, Radiotherapy, and Oncology Department of the North Ossetian State Medical Academy, Russian Ministry of Public Health.
Vladikavkaz.
M. A. Khazhokov
Russian Federation
Murat Askarbievich Khazhokov, Cand.Med.Sc., Head of the ESWL Laboratory at the Adygei Republican Clinical Hospital.
Maikop.
A. V. Ilyash
Russian Federation
Anna Vladimirovna Ilyash, Cand.Med.Sc., Urologist at the Consulting and Outpatient Department of the Rostov State Medical University.
Rostov-on-Don.
V. P. Glukhov
Russian Federation
Vladimir Pavlovich Glukhov, Cand.Med.Sc, Associate Professor at the Department of Urology and Human Reproductive Health with Pediatric Urology and Andrology Course of the Rostov State Medical University.
Rostov-on-Don.
Yu. L. Naboka
Russian Federation
Yulia Lasarevna Naboka, MD, Professor, Head of the Microbiology and Virology Department No. 1 at the Rostov State Medical University, Russian Ministry of Public Health.
Rostov-on-Don.
I. A. Gudima
Russian Federation
Irina Aleksandrovna Gudima, Cand.Med.Sc., Assistant Professor of the Microbiology and Virology Department No. 1 at the Rostov State Medical University, Russian Ministry of Public Health.
Rostov-on-Don.
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Review
For citations:
Khasigov A.V., Khazhokov M.A., Ilyash A.V., Glukhov V.P., Naboka Yu.L., Gudima I.A. EFFECTIVENESS AND SAFETY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR UNCOMPLICATED PELVIC CONCREMENTS. Urology Herald. 2017;5(3):39-48. (In Russ.) https://doi.org/10.21886/2308-6424-2017-5-3-39-48