Extracorporeal shock wave lithotripsy treatment in paraplegic patients with bladder stones.
BACKGROUND
Spinal cord injury patients are at increased risk of developing urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy (ESWL).


METHODS
We examined 20 consecutive spinal cord injury patients (all male) undergoing ESWL for the treatment of bladder stones between April 1992 and May 2000. The mean number of shock waves administered in these 20 patients was 3600 and the shock power was 19 kW/s. All patients were treated without anesthesia. After ESWL, the bladder was irrigated with povidone iodine solution and stone fragments were evacuated through a 22F endoscopic sheath.


RESULTS
All patients became stone-free after ESWL. Stone fragments were observed in the urethra of 3 patients, which were removed by urethroscopy. No major complication was observed; however, 5 patients had minor hematuria (which subsided within 24 h) and subfebrile fever (37.2-37.5 degrees C).


CONCLUSIONS
ESWL and transurethral bladder irrigation is a safe, effective and simple modality for the treatment of bladder stones in spinal cord injury patients.
Kilciler
Mete
M
Department of Urology, Gülhane Military Medical Academy, School of Medicine, Ankara, Turkey.
Sümer
Fahri
F
Bedir
Selahattin
S
Ozgök
Yaşar
Y
Erduran
Dogan
D
D000328:Adult; D006801:Humans; D008096:Lithotripsy; D008297:Male; D017063:Outcome Assessment, Health Care; D010264:Paraplegia / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D007507:Therapeutic Irrigation; D001744:Urinary Bladder Calculi / Q000209:etiology* / Q000628:therapy*