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- Title
Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital.
- Authors
Al-Marhoon, Mohammed S.; Shareef, Omar; Al-Habsi, Ismail S.; Balushi, Ataalrahman S. Al; Mathew, Josephkunju; Venkiteswaran, Krishna P.
- Abstract
Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones. Methods: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. Results: Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85%) had renal stones and 33 (15%) had ureteric stones. The mean±SD stone size was 11.3±4.5 mm, while the mean age of the patients was 39.9±12.8 years with 68.5% males. The mean renal stone size was 11.6±4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9±3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones) was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5%) with renal stones and 13 patients (39.4%) with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones). Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004) and the number of shockwaves (p=0.021). Conclusion: Siemens Modularis Vario lithotripter is a safe and effective tool for treating renal and ureteric stones.
- Subjects
OMAN; LITHOTRIPSY; TREATMENT of calculi; URINARY calculi; ACADEMIC medical centers; CHI-squared test; EPIDEMIOLOGY; HEALTH outcome assessment; PAIN; SUCCESS; LOGISTIC regression analysis; DATA analysis; TREATMENT effectiveness; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
Oman Medical Journal, 2013, Vol 28, Issue 4, p255
- ISSN
1999-768X
- Publication type
Article
- DOI
10.5001/omj.2013.72