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TITLE:

STUDY TO DETERMINE THE EFFICACY OF IN SITU EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR URETERAL STONES

AUTHORS:

Dr Talha Hassan Shah, Dr Muhammad Usman, Dr Bilal Khan

ABSTRACT:

Aim: To evaluate the effectiveness of in situ ESWL for the treatment of ureteral stones. Study design: Prospective interventional quasi experimental study. Place and duration: In the Department of Urology, Jinnah Hospital Lahore for one year duration from March 2019 to March 2020. Methodology: 53 adult men and women with single, upper, middle or lower ureteric calculi undergoing ESWL were selected. All patients were assessed by routine testing, including PT, APTT and IVP. Hypertensive patients were asked to monitor their blood pressure before sending them to in situ ESWL. All patients with upper and mid-ureteric calculi were treated in supine position and patients with lower ureter stones were treated in prone position. All patients were given a laxative the night before surgery to eliminate gases for the correct location of stones and focusing by fluoroscopy. A piezoceramic type lithotripter was used, having both ultrasound and fluoroscopy for focusing the stone, in this study was used. Shock waves were given for sixty-five minutes. Blood pressure in all patients was checked after surgery and unloaded after one hour, when they subsided and you could not complain about hematuria. Stone fragmentation was visualized directly, and stone clearance was checked on an outpatient basis by a simple KUB x-ray one week after lithotripsy. Results: Significant influence of stone site and number of visits was observed, while other epidemiological factors such as age, gender and stone size showed negligible effect on the result. The success rate was 49 (92.5%) of 53 cases. Conclusion: ESWL is an effective method of treating ureter stones, as well as being more beneficial compared to other treatments. This should be the first-line treatment for a single, undisturbed, unilateral, ureteral stone less than or equal to 1.0 cm. KEYWORDS: ESWL, ureter calculations, activity

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