Ullah Sami, Muhammad Syed Razi, Farooque Rizwan, Farooque Umar, Farukhuddin Fnu, Bin Zafar Muhammad Daim, Khadke Chinmay, Usman Ahmad, Perez Julio, Shehata Mostafa A
Urology, Muhammad Medical College, Mirpur Khas, PAK.
Internal Medicine, Sindh Medical College, Karachi, PAK.
Cureus. 2021 Feb 10;13(2):e13271. doi: 10.7759/cureus.13271.
Introduction Urinary lithiasis is usually managed by extracorporeal shock wave lithotripsy (ESWL). Patients are examined using non-contrast computed tomography (NCCT) in order to evaluate the feasibility of ESWL, according to where the stone is located and how big is its size. The objective of this study is to determine the outcomes of ESWL in patients having high-density renal stone, evaluated using NCCT. Materials and methods A descriptive case series study was conducted in the Department of Urology, Sindh Institute of Urology & Transplantation, Karachi for six months. Patients of either gender aged between 25-50 years, who presented with solitary renal and ureteric calculi of 0.5-2 cm in diameter and high-density renal stones [>750 hounsfield units (HU)] were enrolled. ESWL was performed and a satisfactory outcome was defined as complete stone clearance in less than or equal to three ESWL sessions. Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY) was used to analyze frequencies and percentages of the number of ESWL sessions, complete renal stone clearances, and satisfactory outcomes at the end of 12 weeks. A p-value of <0.05 was considered significant. Results The mean age of the patient was reported to be 34.08 ± 9.53 years. 51.6% male preponderance was noticed. Renal and ureteric stones were found in 69.7% and 30.3% of patients, respectively. 21.3% of patients showed stone clearance after two ESWL sessions, 27% of patients after three ESWL sessions, and 51.6% of patients after four ESWL sessions. Stone clearance was found in 58.2% of patients and a satisfactory outcome was found in 42.6% of patients. Conclusions Our results signify a satisfactory outcome of extracorporeal shock wave lithotripsy for high-density renal stone on non-contrast computed tomography. Further studies on a larger scale are needed to validate these results.
引言
尿石症通常采用体外冲击波碎石术(ESWL)进行治疗。根据结石的位置和大小,患者需接受非增强计算机断层扫描(NCCT)检查,以评估ESWL治疗的可行性。本研究的目的是确定经NCCT评估的高密度肾结石患者接受ESWL治疗的效果。
材料与方法
在卡拉奇信德泌尿与移植研究所泌尿外科进行了为期六个月的描述性病例系列研究。纳入年龄在25至50岁之间、患有直径0.5至2厘米的孤立性肾和输尿管结石以及高密度肾结石[>750亨氏单位(HU)]的患者,无论性别。进行了ESWL治疗,将满意的结果定义为在小于或等于三次ESWL治疗后结石完全清除。使用社会科学统计软件包(SPSS)(IBM公司,纽约州阿蒙克)分析ESWL治疗次数、肾结石完全清除率和12周结束时满意结果的频率和百分比。p值<0.05被认为具有统计学意义。
结果
据报告,患者的平均年龄为34.08±9.53岁。发现男性占优势,比例为51.6%。分别有69.7%和30.3%的患者发现肾和输尿管结石。21.3%的患者在两次ESWL治疗后结石清除,27%的患者在三次ESWL治疗后结石清除,51.6%的患者在四次ESWL治疗后结石清除。58.2%的患者结石清除,42.6%的患者获得满意结果。
结论
我们的结果表明,非增强计算机断层扫描显示的高密度肾结石患者接受体外冲击波碎石术的效果令人满意。需要进行更大规模的进一步研究来验证这些结果。