USG Guidance Extra Corporeal Shock Wave Lithotripsy in 30 cases of Renal Calculi

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is a noninvasive procedure that uses shock waves to break up stones in the kidney, including the upper ureter. Ultrasound or X-rays guide the shock waves to the stone's location during the procedure. The patient may lie on a padded table or sit in a tub of water while the shock waves are delivered. To evaluate the outcome of extracorporeal shock wave lithotripsy (ESWL) for upper ureteric calculi of size ≤ 20mm without ureteral stenting. This was a prospective study conducted in the department of Urology BSMMU from July 2023 to August 2024. A total of 30 patients aged between 10 and 70 years with renal calculi underwent ESWL using the Dornier Compact Sigma Lithotripter. Stone size was calculated by measuring the largest dimension of the stone in KUB plain films. In each session, 3000–3500 shocks were given at a frequency of 60–90 per minute and intensity between 1 and 4. A maximum number of five sessions were provided. Successful treatment was defined as complete clearance or residual stones smaller than 4 mm on KUB performed 3 months after the first session. Of 30 patients, the M: F ratio was 1:1.2. The stone size ranged from 5 to 20 mm. The overall success rate was 94.6%. For stones >15 mm, the success rate was only 77.7%. The number of sessions increases as the stone size increases. The most common complication encountered was haematuria. Our study showed ESWL as a primary modality for less than 20mm upper ureteric stones.