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Results for “Extracorporeal shock wave lithotripsy”

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At least 19 recordsLinked to original sources

PubMed1987

Use of local anesthesia for extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy is being performed at many centers with the use of either general or epidural anesthesia. We report our experience with 39 patients treated by extracorporeal shock wave lithotripsy under local anesthesia. These patients tolerated the procedure well and had good fragmentation of the stones. Of the patients 18 were treated on an outpatient basis. In selected patients local anesthesia offers an alternative that can decrease the risk of anesthesia, and reduce the cost and hospital stay associated with extracorporeal shock wave lithotripsy.

Adolescent↗

PubMedDate not supplied

[Iatrogenic rupture of the ureter following extracorporeal shock wave lithotripsy].

Extracorporeal shock wave lithotripsy is the treatment of choice in most cases of urinary calculi, with the estimation that open surgery is only necessary in 5% of all cases. In most cases, the complications derived from this technique are slight, transitory and of little clinical importance, with isolated cases of serious urological or extraurological injury. These complications are either caused by the action of the stone itself or its fragments, or by the action of shock waves. We present a case of ureteral rupture following treatment of a ureteral calculus using extracorporeal shock wave lithotripsy which led to a periureteral retroperitoneal abscess that was treated by nephroureterectomy.

Aged↗

PubMed1986

Report of the United States cooperative study of extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy effectively fragments urinary calculi in the upper urinary tract and upper ureter. These fragments pass completely by 3 months in 77.4 per cent of the patients with single stones. Risk of obstruction, increased postoperative pain, need for additional urological operations and retained fragments are low for stones less than 1 cm. in size. As the number of stones treated or single stone size increases above 1 cm. the risk for these factors increases. Adjunctive urological surgical management is required in 9 per cent of the patients preoperatively and 8 per cent postoperatively. Only 0.6 per cent of the patients require some type of open operation to resolve the stone problems after extracorporeal shock wave lithotripsy. Hemorrhage, obstruction by fragments, severe pain and urinary infection all constitute known complications and require careful urological management of all patients. Hospitalization averages 2 days after treatment and patients usually return to work within a few days after they are discharged from the hospital.

Adult↗

PubMedDate not supplied

Predictions and associations of cholecystectomy in patients with cholecystolithiasis treated with extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is effective in the treatment of symptomatic cholecystolithiasis in well-selected patients. We analyzed the predictors of cholecystectomy in a large series of gallstone patients after ESWL. This was a retrospective follow-up cohort-study of consecutive patients undergoing ESWL for symptomatic cholecystolithiasis over a 9-year period. It was possible to analyze a total of 297 patients; there were 211 women and 86 men, with a mean age of 52 years (range, 8-81 years). Patients that had been cholecystectomized after ESWL were compared to patients with their gallbladder still in situ and determinants of cholecystemctomy in terms of clinical, stone, and gallbladder parameters and symptoms analyzed. The mean duration of follow-up was 99 months (range, 27-134 months). During follow-up, 106 (36%) patients underwent a cholecystectomy at a mean of 34 months (range, 0-127 months) after ESWL. Histological data showed a normal gallbladder wall in only 4 cases; 101 examinations revealed some kind of (chronic) inflammation, which was not different from histological gallbladder results in patients without prior lithotripsy. Three gallbladder polyps were found, but no carcinoma. Cholecystectomy after ESWL of gallbladder stones was strongly associated with persitent and/or renewed biliary symtoms. Nevertheless, only three of four patients became asymptomatic after CE. Thus, ESWL proved to be a valuable organ-preserving alternative to cholecystectomy in selected patients.

Adolescent↗

PubMed1989

Current state and future developments of noninvasive treatment of human urinary stones with extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy has now been in clinical use for 8 years and it has replaced other treatment techniques for the majority of surgical calculi in the upper urinary tract. For the first time it provides a completely noninvasive method for the treatment of renal and ureteral stones. The current range of its indications includes approximately 70 per cent of nonselected urinary stone patients. An additional 25 per cent of the patients with more complex stones in the upper urinary tract can receive treatment with the lithotriptor combined with endourological procedures. More recent additions to the range of clinical routine applications with the original lithotriptor have been its use on common bile duct stones combined with endosurgical or radiological manipulations. With a modified kidney lithotriptor gallstones have been treated successfully, which has led to the development of a multipurpose device for biliary and urinary stones.

Humans↗

PubMed1987

Radiation exposure to patients during extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy is rapidly becoming an accepted treatment of renal calculi. Since fluoroscopy is involved to image the stones it is important to know how much radiation the patient receives during this proCedure. Surface radiation exposure to the patient was measured in more than 300 fluoroscopic and radiographic procedures using thermoluminescent dosimeters. Initial results showed an average skin exposure of 10.1 rad per procedure for each x-ray unit, comparing favorably with exposure rates for percutaneous nephrostolithotomy and other routine radiological procedures. Factors influencing exposure levels include stone characteristics (location, size and opacity), physician experience and number of shocks required. Suggestions are given that may result in a 50 per cent reduction of radiation exposure.

Humans↗

PubMed1998

Splenic rupture and abscess after extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is the first choice for the treatment of most urinary stones. Complications of ESWL can be separated into two groups: those related to the administration of the shock waves and those related to fragmentation and elimination of the stone's particles. We report a rare case of splenic trauma followed by abscess after ESWL.

Abscess↗

PubMed1999

Anti-glomerular basement membrane glomerulonephritis after extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is a common noninvasive procedure for removal of upper urinary tract stones. We present a case of a man who developed anti-glomerular basement membrane (anti-GBM) disease after ESWL and review the two other cases described in the medical literature. In all cases, the affected individuals expressed the HLA DR2/HLA DR15 major histocompatibility antigen and developed a rapidly progressive anti-GBM-induced glomerulonephritis 3 to 7 months after ESWL. Anti-GBM disease may be a rare complication of ESWL in susceptible individuals and should be considered in patients who develop acute renal failure after lithotripsy.

Acute Kidney Injury↗

PubMed2000

Localized dissection and delayed rupture of the abdominal aorta after extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on the kidneys and the surrounding tissues are increasingly recognized. We report on the rupture of a severely calcified abdominal aorta in a 65-year-old man who underwent 3 months of ESWL treatment earlier for renal calculi. The patient was seen with an acute recrudescence of a long-standing abdominal and left flank pain, which began immediately after the last of the three sessions of ESWL and was associated with an episode of hypotension that occurred an hour before admission. Patient history and chronologic course of events strongly suggest the role of ESWL in the genesis of abdominal aorta rupture.

Aged↗

PubMed2006

Acute necrotizing pancreatitis as a rare complication of extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is considered the standard treatment for most renal and upper ureteral stones. Some centers use ESWL to treat bile duct stones and pancreatic calculi. Although ESWL is generally considered safe and effective, major complications, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, rupture of an aortic aneurysm and intracranial hemorrhage, have been reported to occur in less than 1% of patients. Here, we present an extremely rare case of acute necrotizing pancreatitis occurring after ESWL for a right-sided urinary stone, which was treated by non-operative percutaneous interventions.

Adult↗

PubMed1993

Risk of bacteraemia during extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbers of ESWL, more patients prone to infectious complications will be treated. However, little is known about the infectious risks of ESWL. To provide a basis for the rational use of antimicrobial prophylaxis, we studied the incidence of bacteraemia during ESWL. A total of 23 patients with urinary calculi were treated. Blood cultures (4-7 per patient) were taken before, during and immediately after ESWL, adding up to a total of 154 cultures. In 22 of these patients no bacteraemia was detected. In 1 patient small numbers of 2 different micro-organisms were found in 2 blood samples only. This finding, and the circumstances of blood collection, suggested contamination rather than bacteraemia. It was concluded that the risk of bacteraemia during ESWL is very low.

Adult↗

PubMed1986

In-bath filming during extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is now the preferred method for treating most renal calculi. We designed a cassette and grid holder and a technique for filming in the water bath. The excellent film quality permits initial localization of small or faint calculi and confirmation of satisfactory fragmentation during ESWL. The technique facilitates patient treatment and throughput and should reduce the repeat treatment rate.

Humans↗

PubMed1987

Elective treatment of ureteral stones with extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy was used as an elective treatment in 128 ureteral stones. Of the 108 with adequate follow-up, 88% were successfully disintegrated. Ureteral catheters proved to be particularly useful for more precise stone localization and as a mechanical means to push the calculi inside the renal cavities or to create a fluid interface around them, in order to increase the efficiency of the shock waves. When ureteral catheters were used a success rate of 95.5% was observed, as opposed to 82.8% when stents were not used (p less than 0.05).

Follow-Up Studies↗

PubMed1988

[Clinical study of extracorporeal shock wave lithotripsy].

Extracorporeal shock wave lithotripsy was performed on 81 patients with urolithiasis (35 patients with ureteral stones, 25 patients with renal stones less than 2 cm in diameter, and 21 patients with renal stones more than 2 cm in diameter) at Kanbara Hospital from August to October, 1986. A 4 Fr catheter was placed transurethrally in the ureter up to the stone to identify the stone position and the degree of fragmented stones. In four patients with staghorn calculi, a double-J catheter was placed in the ureter to prevent stone street formation. More than 50% of the patients with renal stones less than 2 cm in maximum diameter and ureteral stones had satisfactorily excreted fragments or sand of crushed stones not later than 2 weeks after the operation. However, in patients with renal stones more than 2 cm in maximum diameter, it took much more time to discharge the crushed stones compared with the foregoing two groups and some patients needed further management to remove the remnants. Combined treatment, ureteral catheterization or endoscopic operation with ESWL is recommended for treatment of renal stones larger than 2 cm in diameter.

Adult↗

PubMed1993

[Extracorporeal shock wave lithotripsy].

Extracorporeal shock wave lithotripsy (ESWL) was performed in 84 patients with gallbladder stones. The gallstones completely disappeared within 12 months after ESWL, in 31% of the patients with one to three radiolucent stones not larger than 3 cm in diameter and in 57% of the patients with a solitary stone up to 2 cm with the ultrasonographic gallstone pattern of I a or I b. There was no major complication. ESWL is a safe and effective treatment in selected patients with a solitary radiolucent stone not larger than 2 cm with I a or I b pattern.

Adult↗

PubMed1995

[Urinary excretion of leucine aminopeptidase after extracorporeal shock wave lithotripsy].

Extracorporeal shock-wave lithotripsy (ESWL) is the treatment of choice in the majority of urinary calculi. In experimental and clinical research it has been shown that the method has short-term deleterious effects on renal function. Several factors, such as urinary tract infection (UTI), the site of the stone, pre-existing renal abnormalities, the number and intensity of the shock waves may influence the extent of the damage. The aim of this study was to measure the excretion of the renal microsomal enzyme, leucinaminopeptidase (MLAP) as expression of renal damage following ESWL. Our study shows that there was a significant elevation in urinary excretion of MLAP immediately after ESWL, especially in patients with UTI. These results indicate that UTI may be one of the risk factors for aggravation of renal damage after ESWL. However, these changes are transient and expressed less than in patients with light renal trauma arising because of other external influence.

Adolescent↗

PubMed1987

New generation shock wave lithotripsy.

Extracorporeal shock wave lithotripsy has been clinically successful for more than 5 years. Currently, several devices commonly termed second generation lithotriptors are under experimental or clinical trials. We present a prototype multifunctional urological table that uses a new mode of shock wave generation along with local coupling to the patient. The results of the first 400 treatments are presented after a brief description of pre-clinical experiments. The prototype has been in operation since March 1986. Particular attention is paid to adjuvant endourological measures, which all have been performed on the same table.

Animals↗

PubMed2006

Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy.

PURPOSE: Extracorporeal shock wave lithotripsy is currently accepted as a first line treatment modality for urolithiasis. In obtaining informed consent it is important to inform patients of the stone-free rate with extracorporeal shock wave lithotripsy before surgery. The present study was performed to develop preoperative nomograms for predicting stone-free rates after extracorporeal shock wave lithotripsy. MATERIALS AND METHODS: A total of 435 patients with 507 urinary stones were treated with extracorporeal shock wave lithotripsy with a Dornier Lithotripter D. Patient age, sex, body mass index, number of stone(s) in each treatment, stone length, side and location were evaluated before extracorporeal shock wave lithotripsy, and treatment efficacies were evaluated at 3 months after each session. The treated stones were divided into 2 groups, those in cases that were stone-free with a single extracorporeal shock wave lithotripsy session and those in all other cases. Multivariate analysis was performed using a logistic regression model. The nomograms were developed by repeating the analysis on 200 bootstrap samples. RESULTS: Stone length, location and number were identified as significant variables on multivariate analysis, and a logistic regression model was developed using these variables. The nomograms predicting stone-free rate at 3 months after single extracorporeal shock wave lithotripsy treatment were finally developed from 200 bootstrap samples. In these nomograms the stone-free probability was highest for solitary proximal ureteral stones less than 5 mm in size (93.8%) and lowest for multiple caliceal stones greater than 21 mm (10.5%). CONCLUSIONS: This study demonstrated that stone size, location and number are significant predictors of extracorporeal shock wave lithotripsy outcome. We have developed nomograms for predicting the stone-free rate of extracorporeal shock wave lithotripsy, which is useful for counseling patients with urolithiasis before surgery.

Female↗