International Research Journal of Engineering and Technology (IRJET)
e-ISSN: 2395-0056
Volume: 04 Issue: 07 | July -2017
p-ISSN: 2395-0072
www.irjet.net
Inductive study of ESWL outcomes for proximal and distal ureteric stones Koroush Ebrahimnezhad Gorji1, Fatemeh Niksirat2, Gholamreza Ataei3 1PHD.
medical physics department , Babol university of medical sciences, Babol, Iran medical physics department , Babol university of medical sciences, Babol, Iran 3MS. paramedical school, , Babol university of medical sciences, Babol, Iran ---------------------------------------------------------------------***--------------------------------------------------------------------2. METHOD Abstract - The introduction of ESWL caused a revolution in 2MS.
the treatment of ureteral calculi. In the present study we evaluated the success rates of ESWL in patient with proximal and distal ureteral calculi. Between October 2015 and December 2016, 275 patients were treated with in situ ESWL monotherapy in Khoramabad /IRAN. During the in situ ESWL to determine the place of the stone, only fluoroscopy was used. Data from the 275 patients were prospectively collected for stone size, stone place, number of treatment sessions, and number of shock waves used. From among 275 cases reviewed, 62 % (173) were male and 32 %( 102) female. Stone-free rate was 85.26%, 87.20% and 75.53% for proximal, middle and distal ureteric respectively. Stone-free rate achieved for stones smaller than 15mm was 90.41%. Overall success rate was 82.54% (227 of 275 patients)
Key Words: ESWL, Renal stone, Stone-free rate 1. INTRODUCTION Urinary calculi cause miss function of kidney is a significant disease in developing countries (1, 2). The extracorporeal shock waves lithotripsy (ESWL) was presented in the early 1980s and made a revolution in the management of urolithiasis (3). Nowadays ESWL is one of the most common approaches for the treatment of urolithiasis and ureteric stones (2, 4). Its efficiency ranges from %68 to %84 when is used as a primary treatment option for upper tract stones. It has become the common treatment for simple renal and proximal ureteral calculi with a diameter less than 15mm (5). It is shown that fragmenting the ureteral stones needs higher energy and a greater number of shock waves than those of kidney stones (2). Stone decomposition and clearance of the fragments are really important in stone clearance after ESWL(6). Recommendations of guidelines for the use of ESWL are results of stone size and type, pulse characteristics (such as frequency and gated or un-gated) and number and power of shock waves(7). According to Guidelines of American urological Association, average (SFR) s was 85% and 83% for distal and proximal ureteric stones, respectively(1). There are different attitudes among urologists to use of ESWL for the proximal and middle ureter (2,8, 9). In present study we evaluated the success rates of ESWL in patient with kidney and ureteric calculi. Š 2017, IRJET
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275 patients were treated with in situ ESWL monotherapy in Khoramabad/IRAN Between October 2012 and December 2013. There were no patients with a single kidney and renal anomalous. None of the patients had stents or hypodermic nephrostomies inserted before the therapy. All patients were treated with an electrohydraulic lithotripter (MPL 9000, Dornier GmbH, Germany) under sedoanalgesia on an outpatient basis. Only fluoroscopy was used during the in situ ESWL to determine the place of the stone. The patients were divided into three groups according to the place of the stone: proximal ureteric, main ureteric and distal ureteric; and every group categorized two subgroups according to the age and sex. Patients were appraised with a plain film of the renal, ureter and bladder, intravenous urography and ultrasonography urinalyiss, urine culture and ligation examines before the process. Data from the 275 patients were prospectively collected for stone size, stone place, number of treatment sessions, and number of shock waves used. Therapy was carried out by technician under supervision of a senior urologist who selected the energy and the number of shock waves for each patient. Successes was considered as complete clearance of stones as declared by KUB, ultrasonography and IVU done two weeks after the treatment to permit enough time for clearance. Results based on various places and size was compared in term of clearance rate, number of shock waves and treatment sessions. All statistical calculations were done using SPSS (Statistical Package for the Social Sciences) version 16 3. RESULT A total of 275 patients with urinary stones were treated. From among 275 cases reviewed, 173(62.9%) were male and 102(32.02%) female. The majority of the patients 165(60%), was made up of patients who were 40 years or less, and the other group, 110(40%), was made up of those who were 40 years and more. The success of ESWL in patient was 98.78% and 58.18% for person who was less than 40 years and more than 40 years respectively. The number of patients whose stones were localized in the proximal, middle and distal ureter was 95, 86 and 94, respectively. Stone-free rate was 85.26%, 87.20% and 75.53% for proximal, middle and distal ureteric stones, respectively. Stone-free rate ISO 9001:2008 Certified Journal
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