[What are the predictive factors of the pain during the treatment of kidney stones by extra-corporeal shockwave lithotripsy?].
OBJECTIVE
Identify predictors for selecting patients who requires analgesia during lithotripsy.


METHODS
This is a prospective study over a period of 13 months, 100 patients with kidney stones treated by an electromagnetic lithotripter (siemens; lithoskop) were selected. For the study of subjective pain caused by the ESWL at different times of the session, a visual analog scale (VAS) was used at different times (T) of the session (T0 before shots, T1 at 500 shots, T2 at 1500 shots, T end of treatment). A session was considered painless if VAS≤3. To identify predictors, were investigated association between pain and the different characteristics of patients, kidney stones and the shock wave specifications.


RESULTS
The analytical study showed that pain was correlated with female gender, anxiety score, skin distance stones, parietal distance and the energy of the shock wave. While age, waist circumference, the circumstance found, the projection of stones on the rib and the number of shots had no impact on the level of pain.


CONCLUSIONS
Our study showed that even with an electromagnetic lithotripter third generation; ESWL is still painful leading to the interruption of the session in 29% of cases. Four major predictors of pain leading to the use of sedo-analgesia early in the session were identified.


METHODS
3.
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie. Electronic address: ktari-kamel@hotmail.fr.
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Ktari
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Saidi
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Mahjoub
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Hamdouni
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Macherki
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Ben Khalifa
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Hellara
Service d'urologie, hôpital Fattouma Bourguiba Monastir, avenue Farhat Hached, 5000 Monastir, Tunisie; Faculté de médecine de Monastir, rue Ibn Sina, 5000 Monastir, Tunisie.
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Saad
D001007:Anxiety / Q000150:complications; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D012737:Sex Factors; D064232:Visual Analog Scale
Douleur; Extra-corporeal shockwave lithotripsy; Facteurs prédictifs; Kidney stones; Lithiases rénales; Lithotripsie extracorporelle; Pain predictors