COMPLICATIONS AFTER ESWL IN THE TREATMENT OF RENO-URETERAL LITHIASIS
Abstract:
Introduction: Approximately 80-90% of reno-ureteral calculi have an indication of being solved by Extra Corporeal Shock Wave Lithotripsy (ESWL). Like any therapeutic procedure, extracorporeal lithotripsy may be accompanied by complications. Most are minor complications, but in a lower percentage, major complications can occur. Hematoma is the most serious complication of extracorporeal lithotripsy, fortunately with a low incidence. Acute pyelonephritis (PNA) occurs either due to a pre-existing urinary infection, or by the release of germs inclavated into calculi during fragmentation. Material and method: We used a retrospective study on a group of 1659 patients for which were performed 2287 ESWL treatments by Siemens Lithostar. We note the major complications that occurred after the ESWL treatment and the predisposing factors for complications. Results: Major complications (renal and perirenal hematoma, acute pyelonephritis) represented a percentage of 11.03% of all complications, respectively only 2.05% of all the investigated patients. Our data shows that the presence of hypertension in the patients with urolithiasis is a risk factor for hematoma after treatment (OR: 7.07, CI: 2.48-20.1, p-0.0001). The presence of urinary tract infections before lithotripsy is a risk factor for the occurrence of pyelonephritis after ESWL (OR: 6.9, CI: 2.7-17.3, p-0.0001). Conclusions: Major complications after ESWL appeared in very small percentages. The chances for the lithiasic and hypertensive patient to develop renal hematoma post ESWL, and also for the patient with urinary infection to make post ESWL pyelonephritis, are large.
full text article in Romanian (.RO) |
full text article in English (.EN) |