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Original Research

RMJ. 2011; 36(3): 210-213


Experience with electro-magnetic lithotriptor with an escalating voltage treatment strategy for upper urinary calculi

Abdul Rasheed Shaikh, Nisar Ahmed Shaikh, Abdul Haleem Shaikh, Aijaz Ahmed Memon, K Das, Abdul Fatah Shaikh.

Abstract
Objective: To determine the outcome of treating upper urinary tract calculi with new electro-magnetic lithotripter.
Study Design and Place: Prospective descriptive study was conducted from Nov; 2007 to December, 2010 at department of Nephro-Urology, Chandka Medical College, Larkana.
Patients and Methods: All patients who had renal calculi up to 2.5cm in size were selected on the basis of routine clinical examination, laboratory investigations, X-Ray intravenous urography (I.V.U) and ultra-sonography etc, for extra corporeal shock wave lithotripsy (ESWL) with new electro-magnetic lithotripter(EML). Simple analgesics and sedation was used before the procedure except in children where general anesthesia was used. An escalating voltage treatment strategy was applied.
Results: We treated 720 patients with 4680 sessions (Average 3.3 sessions per patients). Male to Female ratio was 2.4:1. The mean age of the patients was 37 years. The mean radiological stone size was 1.78 cm in diameter. Total 2500 shock-wave therapy session at 60-70 per minute with an escalating voltage treatment strategy of 500 shocks at 12 kV, 1,000 at 14 kV and 1,000 at 16 kV had been given. The mean treatment session was 3.3(range: 01 to 07) per patient. The success rate with complete stone clearances was achieved in 628(88.5%). The complications like pain, haematuria, obstruction and steinstrasse was observed in 22%, 20%, 8.5% and 3.4% respectively. The mean follow-up was 2.6(range 1-5 months) months.
Conclusion: We conclude that upper urinary tract stone up to 2 cm in diameter is better treated with electro magnetic lithotripter shock wave lithotripsy. It is safe, friendly user and yields higher stone-free and lower re-treatment rates.

Key words: Renal ureteric Stone, ESWL, urolithiasis



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