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Complications in extracorporeal shockwave lithotripsy : a cohort study

Wagenius, Magnus LU ; Jakobsson, Jon; Stranne, Johan and Linder, Adam LU (2017) In Scandinavian Journal of Urology2013-01-01+01:00 p.1-7
Abstract

Objective: The aim of this study was to evaluate clinically relevant complications within 14 days after extracorporeal shockwave lithotripsy (ESWL) in a modern setting. Materials and methods: Consecutive ESWL treatments between 2009 and 2015 in Ängelholm Hospital, Sweden, were analyzed retrospectively. The primary outcome was complications in patients seeking medical attention within 14 days after ESWL. Multivariable analysis was used to adjust for confounders such as diabetes, stone size and location, and presence of a urinary stent. Results: In total, 1838 stones were treated: 1185 (64.4%) localized in the renal pelvis, and 415 (22.5%) in the upper two-thirds and 205 (11.1%) in the lower third of the ureter. Overall, 116 out of 1838... (More)

Objective: The aim of this study was to evaluate clinically relevant complications within 14 days after extracorporeal shockwave lithotripsy (ESWL) in a modern setting. Materials and methods: Consecutive ESWL treatments between 2009 and 2015 in Ängelholm Hospital, Sweden, were analyzed retrospectively. The primary outcome was complications in patients seeking medical attention within 14 days after ESWL. Multivariable analysis was used to adjust for confounders such as diabetes, stone size and location, and presence of a urinary stent. Results: In total, 1838 stones were treated: 1185 (64.4%) localized in the renal pelvis, and 415 (22.5%) in the upper two-thirds and 205 (11.1%) in the lower third of the ureter. Overall, 116 out of 1838 cases (6.4%) needed medical attention within 14 days after ESWL and 75 (4%) crequired hospital care. Infection was found in 44 cases (2.4%), with a positive urine culture in 33 cases. Invasive/operative interventions were performed in 41 cases (2.2%). Distal stones had a lower risk of complications (p = 0.02) with ESWL. Diabetes (p = 0.02), larger stones (11–20 mm, p = 0.03; 21–30 mm, p = 0.009) and a need for antiemetics during treatment (p = 0.02) were significantly associated with an increased risk of complications. Conclusions: Few complications are associated with modern ESWL treatment. A frequency of 1 Hz should be used to reduce complications (p = 0.025). Diabetes and larger stone size increase the risk of complications. The need for antiemetics during ESWL requires special consideration and further study. Distal stones seem to carry a lower risk of complications (p = 0.017).

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author
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Complications, extracorporeal shockwave lithotripsy, infection, monotherapy, ureteric stone, ureteroscopy
in
Scandinavian Journal of Urology2013-01-01+01:00
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85026881142
ISSN
2168-1805
DOI
10.1080/21681805.2017.1347821
language
English
LU publication?
yes
id
97f09fba-08d3-472e-9fcd-496fa5e9a7d4
date added to LUP
2017-08-21 11:31:03
date last changed
2017-08-22 03:00:03
@article{97f09fba-08d3-472e-9fcd-496fa5e9a7d4,
  abstract     = {<p>Objective: The aim of this study was to evaluate clinically relevant complications within 14 days after extracorporeal shockwave lithotripsy (ESWL) in a modern setting. Materials and methods: Consecutive ESWL treatments between 2009 and 2015 in Ängelholm Hospital, Sweden, were analyzed retrospectively. The primary outcome was complications in patients seeking medical attention within 14 days after ESWL. Multivariable analysis was used to adjust for confounders such as diabetes, stone size and location, and presence of a urinary stent. Results: In total, 1838 stones were treated: 1185 (64.4%) localized in the renal pelvis, and 415 (22.5%) in the upper two-thirds and 205 (11.1%) in the lower third of the ureter. Overall, 116 out of 1838 cases (6.4%) needed medical attention within 14 days after ESWL and 75 (4%) crequired hospital care. Infection was found in 44 cases (2.4%), with a positive urine culture in 33 cases. Invasive/operative interventions were performed in 41 cases (2.2%). Distal stones had a lower risk of complications (p = 0.02) with ESWL. Diabetes (p = 0.02), larger stones (11–20 mm, p = 0.03; 21–30 mm, p = 0.009) and a need for antiemetics during treatment (p = 0.02) were significantly associated with an increased risk of complications. Conclusions: Few complications are associated with modern ESWL treatment. A frequency of 1 Hz should be used to reduce complications (p = 0.025). Diabetes and larger stone size increase the risk of complications. The need for antiemetics during ESWL requires special consideration and further study. Distal stones seem to carry a lower risk of complications (p = 0.017).</p>},
  author       = {Wagenius, Magnus and Jakobsson, Jon and Stranne, Johan and Linder, Adam},
  issn         = {2168-1805},
  keyword      = {Complications,extracorporeal shockwave lithotripsy,infection,monotherapy,ureteric stone,ureteroscopy},
  language     = {eng},
  month        = {08},
  pages        = {1--7},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Complications in extracorporeal shockwave lithotripsy : a cohort study},
  url          = {http://dx.doi.org/10.1080/21681805.2017.1347821},
  year         = {2017},
}