Extracorporeal schok wave lithotripsy (ESWL) - experience of the Departament of Urology Republican Clinical Hospital

Abstract

Introduction: In present days, in Republic of Moldova, extracorporeal shock wave lithotripsy (ESWL) is a usual form of treatment for renoureteral lithiasis. The purpose of this work is to evaluate the results after treatment of urolithiasis with extracorporeal shock wave lithotripsy in our clinic. Material and Methods: During August 2011 - December 2011, a number of 190 patients were treated by ESWL for renoureteral lithiasis and a number of 243 treatment procedures were performed. The device we have is a second generation MODULITH" SLK lithotripter, with radiological and ultrasonographic localization system. In a number of 115 patients the localization of calculi was renal (60,52%), in 75 cases (39,47%) was ureteral localization. Results: In a number of 120 patients (63,15%) ESWL was the single method used for therapy. A number of associated methods of treatment (percutaneous nephrostomy, ureteral catheter,) was necessary for 25 patients (13,15%). ESWL was made in 10 patients with a single kidney (5,26%). 40 (21,05%) patients were necessary two treatments, with in 3 (1,57%) patients three treatments or more were used. Severe complications occurred in 11 % cases (sepsis, anuria, perirenal hematoma, steinstrasse, etc.) Conclusions: 1. ESWL is a very common method of treatment of renoureteral lithiasis and indication of primary treatement is about 70%. 2. Associated methods (percutaneous nephrostomy, autostatic ureteral catheter, etc) were necessary before or after the procedure in case of non fragmentation or complications. 3. Severe complications lead to a adequate therapy (internal or external drainage of urinary system in urosepsis), and in the perirenal hematoma in evolution - open surgery.