EFFICACY AND SAFETY OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) IN PIELIC STONES AND INFECTED HYDRONEPHROSIS AFTER DOUBLE-J STENT INSERTION

  • V.D. RADU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R.C. COSTACHE “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • P. ONOFREI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • B. NOVAC “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R.F. ANDRICIUC “C. I. Parhon” University Hospital, Iasi, Romania
  • R. OUATU “C. I. Parhon” University Hospital, Iasi, Romania
  • D. ARSENI “C. I. Parhon” University Hospital, Iasi, Romania
  • T.F. PANTILIMONESCU “C. I. Parhon” University Hospital, Iasi, Romania
  • Carina-Alexandra BANDAC “C. I. Parhon” University Hospital, Iasi, Romania

Abstract

Extracorporeal shockwave lithotripsy (ESWL), along with flexible retrograde ureteroscopy (RIRS), is the treatment of first choice for pelvic stones up to 10 mm, and double-J catheters are not routinely inserted prior to the procedure. However, their insertion is mandatory in patients with infected secondary hydronephrosis. The aim of the study was to evaluate the efficacy and safety of ESWL in this particular group of patients compared to patients without double-J ureteral catheters. Materials and methods: We conducted a retrospective case-control study of patients with pelvic stones up to 10 mm in whom a double-J ureteral catheter was inserted due to infected hydronephrosis and subsequently underwent ESWL between January 1, 2018 and December 31, 2023. As a control group, we included the patients with pelvic stones without a double-J catheter who underwent ESWL during the same period. We analyzed the demographic data, the stone-free rate and the occurrence of complications in the two patient groups. Results: We identified a number of 46 patients with double-J catheters and a number of 118 patients without double-J catheters who underwent ESWL for pelvic stones up to 10 mm. Patients in both groups were over 46 years of age, were predominantly male and had a body mass index (BMI) between 25 and 29.9. There were no statistically significant differences between the 2 groups in terms of stone-free rate, both after the first (78.3% vs. 73.7%, p=0.866), second (89.58% vs. 89.8%) and third ESWL sessions (93.7% vs. 95.7%, p=0.583). The complication rate was reduced in both groups, with no statistically significant differences (14.6% vs. 6.77%, p=0.324). Conclusions: The presence of double-J ureteral catheters inserted due to infected hydronephrosis did not reduce the efficacy of ESWL in patients with pelvic stones up to 10 mm. In this patient group, ESWL can be recommended as a first-line treatment alongside RIRS.

Author Biographies

V.D. RADU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgical Specialties (II)
“C. I. Parhon” University Hospital, Iasi, Romania
3. Department of Urology and Renal Transplantation

R.C. COSTACHE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgical Specialties (II)
“C. I. Parhon” University Hospital, Iasi, Romania
Department of Urology and Renal Transplantation

P. ONOFREI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Department of Morpho-Functional Sciences (II)
“Elytis Hope” Hospital, Iasi, Romania
Department of Urology

B. NOVAC, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Department of Surgical Specialties (II)
“C. I. Parhon” University Hospital, Iasi, Romania
Department of Urology and Renal Transplantation

R.F. ANDRICIUC, “C. I. Parhon” University Hospital, Iasi, Romania

Department of Urology and Renal Transplantation

R. OUATU, “C. I. Parhon” University Hospital, Iasi, Romania

Department of Urology and Renal Transplantation

D. ARSENI, “C. I. Parhon” University Hospital, Iasi, Romania

Department of Urology and Renal Transplantation

T.F. PANTILIMONESCU, “C. I. Parhon” University Hospital, Iasi, Romania

Department of Urology and Renal Transplantation

Carina-Alexandra BANDAC, “C. I. Parhon” University Hospital, Iasi, Romania

Department of Urology and Renal Transplantation

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Published
2024-03-29