Percutaneous nephrolithotomy in new versus those patients with previous history of Extracorporeal Shock Wave Lithotripsy on ipsilateral side (original) (raw)
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Arab Journal of Urology
To evaluate the effects of previous unsuccessful extracorporeal shockwave lithotripsy (ESWL) treatment on the performance and outcome of percutaneous nephrolithotomy (PCNL). Patients and methods: Of 1625 PCNL procedures performed in our clinic, 393 renal units with similar stone burden and number of accesses was included in the present study. We categorised the study patients into two groups according to whether they underwent ESWL within 1 year prior to PCNL or not. Accordingly, Group 1 comprised 143 (36.3%) ESWL-treated patients and Group 2 comprised 250 (63.7%) non-ESWL-treated patients. Results: Residual stones were detected in 36 (25.1%) of the ESWL-treated patients (Group 1) and in 60 (24%) of non-ESWL-treated patients (Group 2). There were no statistically significant differences between the groups for length of hospital stay (LOS), nephrostomy tube removal time, and the presence of residual stones. When we evaluated the groups for both the preoperative and postoperative haemoglobin (Hb) drop and blood transfusion rate, manifest Hb declines and more transfusions were required in the ESWL-treated patients (both P = 0.01).
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011
OBJECTIVE To estimate and compare the incidence rate of kidney stone recurrence and regrowth after ESWL with PCNL at one, two, and three years. MATERIAL AND METHOD A retrospective cohort study was performed The study recruited patients aged more than 18 years, diagnosed with kidney stones and treated by ESWL or PCNL between January 2006 and August 2010 at the urological unit of a university hospital located in the northern part of Thailand. Data were retrieved from medical records and analyzed using exact probability test or student's t-test. Poisson regression was used to compare the recurrence rate and the regrowth rate between ESWL and PCNL. RESULTS During three years of follow-up, the overall stones recurrence and regrowth were 15.5% and 25.1% in ESWL group and 12.6% and 16% in PCNL group, repectively. At one, two and three years after treatment, stones recurrence rate in the ESWL group were 13.1, 7.5 and 7.3 per 1,000 patient-months while in the PCNL group were 11.3, 6.1 an...
European Urology Supplements, 2016
To investigate the effect of stone fragmentation on late stone recurrence by comparing the outcome of extracorporeal shockwave lithotripsy (ESWL) and non-fragmenting percutaneous nephrolithotomy (PCNL), and to investigate factors contributing to recurrent calculi. Patients and methods: We evaluated stone recurrence in 647 patients who initially achieved a stone-free status after ESWL and compared the outcomes to 137 stonefree patients treated with PCNL without stone fragmentation. Patients were evaluated every 3 months during the first year and every 6 months thereafter to censorship or time of first new stone formation. Stone recurrence rates were calculated using the Kaplan-Meier method. The effects of demographics, stone characteristics, and intervention on the recurrence rate were studied using the log-rank test and the Coxregression analysis. Results: For ESWL the recurrence rates were 0.8%, 35.8% and 60.1% after 1, 5 and 10 years, which were comparable to the 1.5%, 35.5% and 74.9%, respectively found in the PCNL group (P = 0.57). Stone burden (>8 mm) and a previous history of stone disease were significantly associated with higher recurrence rates regardless of the method of stone intervention (P = 0.
Journal of Endoluminal Endourology
Background and ObjectivesPercutaneous nephrolithotomy (PCNL) occupies an essential place in the treatment of upper urinary tract calculi. PCNL also accomplishes higher stone-free rates and requires fewer auxiliary procedures than shock wave lithotripsy (SWL) and ureterorenoscopy (URS) for renal stones between 1–2 cm. There are different intracorporeal lithotripter devices available. This study aims to compare the efficacy and safety of holmium laser, pneumatic lithotripsy and Shock Pulse in PCNL. Materials and MethodsA prospective randomized study was performed in Gauhati Medical College & Hospital, Guwahati, Assam, India, between October 2016 to November 2018. Patients of renal calculi and upper ureteric calculi less than or equal to 2.5cms and functioning kidney on the ipsilateral side were included. 300 patients were randomized according to a random number generator. In the holmium laser, pneumatic and Shock Pulse groups’ number of patients was 96, 102, 102 respectively. Stone di...
Urolithiasis, 2017
The objective of this study was to determine risk factors of hospital admission for treatment of complications after extracorporeal shock wave lithotripsy (SWL). The electronic files and images of all patients who underwent SWL for treatment of renal stones between January 2011 and December 2015 were retrospectively reviewed. All patients underwent SWL with the same electromagnetic lithotripter (Dornier Lithotripot S). The data of those who needed hospital admission for treatment of complications within 30 days after SWL were compared with patients who did not require hospital admission. Compared data included patients' demographics (age, gender, BMI, ASA score, and pre-SWL stenting), renal characters (side, hydronephrosis, and solitary kidney), and stone characters (site, length, density, and previous treatment). Univariate and multivariate statistical analyses were used to identify risk factors. The study included 1179 patients. Complications that required hospital admission w...
Arab Journal of Urology, 2016
To investigate the effect of stone fragmentation on late stone recurrence by comparing the outcome of extracorporeal shockwave lithotripsy (ESWL) and non-fragmenting percutaneous nephrolithotomy (PCNL), and to investigate factors contributing to recurrent calculi. Patients and methods: We evaluated stone recurrence in 647 patients who initially achieved a stone-free status after ESWL and compared the outcomes to 137 stonefree patients treated with PCNL without stone fragmentation. Patients were evaluated every 3 months during the first year and every 6 months thereafter to censorship or time of first new stone formation. Stone recurrence rates were calculated using the Kaplan-Meier method. The effects of demographics, stone characteristics, and intervention on the recurrence rate were studied using the log-rank test and the Coxregression analysis. Results: For ESWL the recurrence rates were 0.8%, 35.8% and 60.1% after 1, 5 and 10 years, which were comparable to the 1.5%, 35.5% and 74.9%, respectively found in the PCNL group (P = 0.57). Stone burden (>8 mm) and a previous history of stone disease were significantly associated with higher recurrence rates regardless of the method of stone intervention (P = 0.
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Although shockwave lithotripsy is introduced 3 decades ago still it is the first line surgical management to meet huge burden of urinary stones worldwide, despite availability of other newer modalities of effective treatment. For developing countries like India, it is very helpful and promising to meet demand of huge burden of patients with less number of urologist. Our aim was to study the efficacy and outcome of this procedure in our institute and how it is influencing the guidelines. Materials and methods: A prospective study over a period of two years was conducted in the department of urology in VIMSAR, Burla with patients 15-60 years age having single solitary stone of below 2cm size in the kidney and below 1 cm size for upper ureteric stone. Efficacy and outcome were calculated as rate of stone clearance, percentage of complications. Statistical analysis was performed. Results: A statistically significant 85.3% of patients get cleared and labelled stone free. Whereas 14.7% of patients having incomplete clearance switched over to other modality of treatment. A 20.6% of patients reported transient pain and other complication treated with appropriate medication which gradually subsided in follow-up. Conclusion: ESWL is the first line of management for renal and upper ureteric calculus in properly selected patients as it is non-invasive, economical, efficacious with minimal complication and can be done as day care procedure.
European Urology Supplements, 2015
Objective: To evaluate the efficacy and safety of immediate versus delayed shockwave lithotripsy (SWL) for inaccessible stones after uncomplicated percutaneous nephrolithotomy (PCNL). Patients and methods: Between December 2011 and June 2014, patients with residual inaccessible stones after uncomplicated PCNL were prospectively randomised into two treatment groups; Group I, immediate SWL and Group II, delayed SWL at 1 week after PCNL. Patients with residual stones of P1.5 cm, a stone density of >1000 Hounsfield units and body mass index of >40 kg/m 2 were excluded from the study. The following data were reported: patients' demographics, stone characteristics after PCNL, hospital stay, perioperative complications, stent duration, and stone-free rate (SFR). Results: In all, 84 patients (51 males and 33 females) with mean (SD) age of 39 (8.5) years were included in the study. Group I included 44 patients, whilst Group II included 40 patients. There was no statistically significant difference amongst the groups for patients' demographics, stone characteristics, and perioperative complications. The hospital stay was significantly shorter in Group I, at a mean
Arab Journal of Urology, 2017
Objective: To evaluate the efficacy and safety of immediate versus delayed shockwave lithotripsy (SWL) for inaccessible stones after uncomplicated percutaneous nephrolithotomy (PCNL). Patients and methods: Between December 2011 and June 2014, patients with residual inaccessible stones after uncomplicated PCNL were prospectively randomised into two treatment groups; Group I, immediate SWL and Group II, delayed SWL at 1 week after PCNL. Patients with residual stones of P1.5 cm, a stone density of >1000 Hounsfield units and body mass index of >40 kg/m 2 were excluded from the study. The following data were reported: patients' demographics, stone characteristics after PCNL, hospital stay, perioperative complications, stent duration, and stone-free rate (SFR). Results: In all, 84 patients (51 males and 33 females) with mean (SD) age of 39 (8.5) years were included in the study. Group I included 44 patients, whilst Group II included 40 patients. There was no statistically significant difference amongst the groups for patients' demographics, stone characteristics, and perioperative complications. The hospital stay was significantly shorter in Group I, at a mean