[Treatment of urosepsis induced by extracorporeal shock wave lithotripsy: analysis of 4 cases].

OBJECTIVE

To evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).

METHODS

The clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011.

RESULTS

Two of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E. coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy, and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged.

CONCLUSION

ESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.