Abstract
Background: Pakistan lies in the Afro-Asia stone belt. Ureteric calculi are common occurrence and a major burden on health care facilities in Pakistan. The objective of this study was to assess the efficacy and safety of pneumatic lithoclast in the management of ureteric calculi.Methods:Case series study Department of Urology at Institute of Kidney Diseases Hayatabad Peshawar, from 1st Oct 2010 to 1st Oct 2011. One-hundred adult patients with ureteric calculi ≥ 0.7cm were evaluated by history, physical examination, routine blood and urine examination after taking their written informed consent and approval of ethical committee. Ultrasound and X-ray KUB were done with IVU if required. All patients underwent ureteroscopy withinintracorporeal lithotripsy and JJ stenting. Patients were followed up withpost-op X-ray KUB at 24 hours and then weekly intervals till they became stone free. Following parameters were assessed:stone size, site, laterality, degree of fragmentation, success rate, stone migration and complications.InabilitytoreachthecalculuswithURS,proximal migration of stoneorrequirementofanother/auxiliary procedure was considered failure.Results:One hundredand ten patients were enrolled with a mean age of 38±10 years. There were 72 males and 28 females.Fifty-eight calculi were on rightand 42 on left side.24, 24 and 52 stones were in upper, middle and lower ureter respectively. Forty stones measured 7–10 mm, 52 measured 11–15 mm and 8 measured 16–20mm in size. 98 stones were broken while 2 calculi migrated proximally. Overall success rate was 90% (Efficiency Quotient =78.95).Success ratein upper, middle and lower ureter was 83.3%, 83.3% and 96.1% respectively. 10and 2 patients required ESWLand open ureterolithotomy, respectively, as additional treatment. Mean operative time was 33.5 minutes.There were no major complications.Conclusions:Pneumatic lithoclast with URS is effective and safe in the management of the ureteric calculi withsome limitations in the upper urete
Dr. Ahmad Nawaz, , Bakhtawar Gul Wazir,, Akhtar Nawaz Orakzai,. (2016) EARLY EXPERIENCE OF PNEUMATIC LITHOCLAST FOR THE MANAGEMENT OF URETERIC STONES AT PESHAWAR, JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD, Volume 28, Issue 3.
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