Outcomes of extracorporeal induced destruction of urinary tract stones by shock waves lithotripsy and its associated factors among patients at French Medical Institute for Children (FMIC), Afghanistan
Date of Award
Diploma in Paediatric Surgery
French Medical Institute for Children (FMIC)
Background: Extracorporeal Shock Wave Lithotripsy (ESWL) has now been in clinical use for years and it has replaced other treatment techniques for the treatment of Urinary Tract Calculi. ESWL is a non-invasive method for the treatment of renal and ureteral stones. The current range of its indications includes majority of non-selected urinary stone treatment. It is used among the patients with more complex stones in the urinary tract. It has revolutionized the treatment of urinary calculi and it should be considered the treatment of choice for renal stones smaller than 2 cms. The success rate of this procedure is ranging from 60 to 90% in the available literature. To the best of researcher’s knowledge, no published data related to the outcomes and factors associated with Lithotripsy among patients with Urinary Tract stones is available in Afghanistan context.
Objective: The current study is aimed to determine the outcomes of Extracorporeal Shock Wave Lithotripsy in the treatment of urinary tract stones and its associated factors at French Medical Institute for Children, Kabul Afghanistan.
Methodology: An analytical hospital based retrospective study design was employed. Records of 293 participants who had undergone Lithotripsy procedure at FMIC hospital with the help of a structured check list was extracted by using purposive sampling. The data was collected from the available records during the period of 2008 to 2015. Chi-square test XII of indepedence was run to identify the factors associated with outcomes of Lithotripsy procedure.
Results: Our study findings have identified the overall success rate of Lithotripsy procedure as 68.4%. The findings of the study have also revealed that majority of the participants 51.36% had successful, 5.12% of participants had partially and 43.20% of participants’ stones had incomplete broken stones as an outcome of first time Lithotripsy. Among patients, who had undergone second time Lithotripsy procedure, 60.97% had successful and 39.02 % had unsuccessful broken stones. Factors like gender and size of stone were significantly associated with outcomes of first time lithotripsy in this population. On the other hand, we could not determine any association between successful outcomes and second time lithotripsy.
Conclusion: Extracorporeal Shock Wave Lithotripsy is one of the cheap and non-invasive, procedures which induce fewer complications which can be managed spontaneously in short period of time. The findings of this study and the available literature shows that ESWL is an effective procedure for the management of Urinary Calculi. Our study has reported a success rate of lithotripsy as around 68% which is remarkable and clearly highlights the effectiveness of this procedure. In addition, our study, also determined gender and stone size as predictors for the successful outcomes of first time lithotripsy. Implementing the relevant strategies will potentially help in decreasing the magnitude of Renal Calculi in Afghanistan.
Salami, J. (2016). Outcomes of extracorporeal induced destruction of urinary tract stones by shock waves lithotripsy and its associated factors among patients at French Medical Institute for Children (FMIC), Afghanistan (Unpublished doctoral thesis). FMIC, Kabul, Afghanistan.