Extracorporeal shock wave lithotripsy in patients with nephrolithiasis: treatment features associated with a high risk of thromboembolic complications | Ukrainian Medical Journal

Kiriienko T.V.,Boyko A.I.

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Extracorporeal shock wave lithotripsy in patients with nephrolithiasis: treatment features associated with a high risk of thromboembolic complications

Extracorporeal shock wave lithotripsy in patients with nephrolithiasis: treatment features associated with a high risk of thromboembolic complications

March 11, 2025

Nephrology and Urology

Surgery

Kiriienko T.V.

Boyko A.I.

УДК: 616.329-003.5-089.844:616-005.8

DOI: 10.32471/umj.1680-3051.263876

Keywords :

calculi,

extracorporeal shock wave lithotripsy,

haematuria,

nephrolithiasis,

renal haematoma,

thromboembolic complications

Specialities :

Nephrology and Urology

Surgery

Resume

Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment modality for urolithiasis. The overall stone-free rate varies significantly. This study aimed to assess the impact of stone size, location, density, and the risk of thromboembolic complications on ESWL outcomes. We analysed treatment outcomes in 159 patients with nephrolithiasis. Based on the thromboembolic risk assessed using the American Society of Anesthesiologists scale, the patient cohort was divided into two groups: Ia (low risk) and Ib (high risk), comprising 100 and 59 patients, respectively. Group Ia included 67 (67.0%) men and 33 (33.0%) women, while Group Ib comprised 41 (69.49%) men and 18 (30.51%) women. Upon hospital admission, a comprehensive history was obtained, symptom duration of nephrolithiasis was recorded, and body mass index (BMI) was calculated. A thorough laboratory evaluation was conducted, including complete blood count, biochemical blood tests, and urinalysis. Computed tomography was used to determine the size, location, and density of renal calculi. The key efficacy criteria for ESWL included the number of treatment sessions, incidence of complications (haematuria and renal haematoma), need for additional surgical intervention, total hospitalisation duration, and the SFR score. Statistical analysis involved a univariate chi-square test and Student’s t-test. IBM SPSS Statistics Version 29.0.1.0 was used for data processing. The findings confirm that ESWL is the preferred treatment option for stones of any location (except the lower calyceal group) with a size of 4–10 mm and a density of up to 1100 HU. However, for stones exceeding 1 cm, those with a density greater than 1100 HU, or those located in the lower calyceal group, an alternative surgical treatment for nephrolithiasis—percutaneous nephrolithotomy—is recommended to prevent complications such as macrohaematuria and renal haematoma.

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