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Is an excretory urogram mandatory in patients with small to medium-sized renal and ureteric stones treated by extra corporeal shock wave lithotripsy?

Ather MH, Faruqui N, Akhtar S, Sulaiman MN - BMC Med (2004)

Bottom Line: The groups were matched in terms of age and gender, as well as location, side and size of stones.The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group.The complication rate and need for ancillary procedures was comparable across the three groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan. hammad.ather@aku.edu

ABSTRACT

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.

Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray kidney, ureter and bladder (KUB). The groups were matched in terms of age and gender, as well as location, side and size of stones.

Results: There was no statistically significantly difference for number of ESWL sessions, number of shock waves and use of ancillary procedures between the three groups. The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group.

Conclusions: The complication rate and need for ancillary procedures was comparable across the three groups. Patients imaged by UHCT or US + X-ray KUB prior to ESWL for uncomplicated renal and ureteric stones do not require IVU.

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Related in: MedlinePlus

Difference in the complication rate in various groups. KUB = kidney, ureter and bladder; UHCT = non-contrast enhanced helical computed tomography; US = ultrasound; UTI = urinary tract infection; IVU = intravenous urogram.
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Figure 1: Difference in the complication rate in various groups. KUB = kidney, ureter and bladder; UHCT = non-contrast enhanced helical computed tomography; US = ultrasound; UTI = urinary tract infection; IVU = intravenous urogram.

Mentions: Overall 11% of patients had significant complications. Six patients in the IVU group and two in the US + X-ray KUB group developed steinstrasse, although the difference was not statistically significant (P = 0.43). Similarly, five patients – one in each of the IVU and US + X-ray KUB groups, and three in the UHCT group – developed colic, and required admission (Figure 1). Two patients developed a post-treatment urinary tract infection.


Is an excretory urogram mandatory in patients with small to medium-sized renal and ureteric stones treated by extra corporeal shock wave lithotripsy?

Ather MH, Faruqui N, Akhtar S, Sulaiman MN - BMC Med (2004)

Difference in the complication rate in various groups. KUB = kidney, ureter and bladder; UHCT = non-contrast enhanced helical computed tomography; US = ultrasound; UTI = urinary tract infection; IVU = intravenous urogram.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC411063&req=5

Figure 1: Difference in the complication rate in various groups. KUB = kidney, ureter and bladder; UHCT = non-contrast enhanced helical computed tomography; US = ultrasound; UTI = urinary tract infection; IVU = intravenous urogram.
Mentions: Overall 11% of patients had significant complications. Six patients in the IVU group and two in the US + X-ray KUB group developed steinstrasse, although the difference was not statistically significant (P = 0.43). Similarly, five patients – one in each of the IVU and US + X-ray KUB groups, and three in the UHCT group – developed colic, and required admission (Figure 1). Two patients developed a post-treatment urinary tract infection.

Bottom Line: The groups were matched in terms of age and gender, as well as location, side and size of stones.The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group.The complication rate and need for ancillary procedures was comparable across the three groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan. hammad.ather@aku.edu

ABSTRACT

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.

Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray kidney, ureter and bladder (KUB). The groups were matched in terms of age and gender, as well as location, side and size of stones.

Results: There was no statistically significantly difference for number of ESWL sessions, number of shock waves and use of ancillary procedures between the three groups. The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group.

Conclusions: The complication rate and need for ancillary procedures was comparable across the three groups. Patients imaged by UHCT or US + X-ray KUB prior to ESWL for uncomplicated renal and ureteric stones do not require IVU.

Show MeSH
Related in: MedlinePlus