Ahmed Abdulameer Alwan1, Falah Mahdi Ali*, Mohameed Abdulraheem Ali
Urinary stone disease is a major health care problem due to its high prevalence and incidence. The aim of the study is to evaluate the safety and efficacy of ESWL lithotripsy as a primary modality of treatment for upper ureteric stones. From October 2011 to October 2016, 400 patients (300 male and 100 female) with upper ureteral stones were admitted to Al-Diwaniya teaching hospital, urology unit and enrolled in this study, their age range from 18 to 65 years with a mean age of 40 ± 3 years. All patients were evaluated by history, physical examination, laboratory investigation (including urinalysis, full blood count, coagulation profile and renal function tests). The stone size, location, opacity and degree of obstruction were assessed by preoperative radiographic imaging studies, including KUB, ultrasound and computerized tomography (CT scan). The overall stone-free rate at three months was 95% (380/400). Clearance after first sitting was 70% (280/400), after second sitting was 20% (80/400) and after third sitting was 5% (20/400). Clearance of stone in patients with stone size ≤ 1 cm was 97% (388/400), and in patients with stone size > 1cm was 5% (340/400). Five per cent (20) of cases did not have successful outcome. In conclusion, the results of our study show that ESWL as a primary modality for upper ureteric stones treatment has an overall success rate of 95%. Success rate drops with increasing size of stone, duration of stone in ureter, and no anesthesia is required.
Keywords: ESWL lithotripsy; Ureteric stones; KUB