Is an excretory urogram mandatory in patients with small to medium-sized renal and ureteric stones treated by extra corporeal shock wave lithotripsy?
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.
Ather
M Hammad
MH
Department of Surgery, Aga Khan University, Karachi, Pakistan. hammad.ather@aku.edu
Faruqui
Nuzhat
N
Akhtar
Sobia
S
Sulaiman
M Nasir
MN
D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000628:therapy; D008096:Lithotripsy / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000009:adverse effects; D014463:Ultrasonography / Q000009:adverse effects; D014514:Ureteral Calculi / Q000000981:diagnostic imaging* / Q000628:therapy