FREQUENCY, SEVERITY, CAUSES OF DEVELOPMENT OF COMPLICATED PYELONEPHRITIS AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY AND PREVENTION METHODS
Keywords:
urolithiasis, ESWL, infectious-inflammatory, complicationsAbstract
Purpose of the study. Improving the results of extracorporeal shock wave lithotripsy by reducing the frequency and severity of postoperative infectious and inflammatory complications.
Material and methods. We have analyzed the results of treatment of 330 patients with urolithiasis who applied to the RSSPM Center of Urology in the period from January 2019 to July 2022 with the stone/s of the upper urinary tract (URT). The first control group consisted of 200 patients subjected to ESWL with the study of the frequency, severity and causes of acute complicated pyelonephritis. The size of the stones was 9.0 ± 0.2 (4-16 mm), in 71 (35.5%) stones were located in the pelvicalyceal system (PCS), in 129 (64.5%) in the ureter. 146 (73%) had urinary tract infection.
Results. Among the 1st group of patients, the "stone free rate" was 186 (93.0%), in the post-procedural period, acute complicated pyelonephritis was observed in 2 (1.0%), urosepsis in 1 (0.5%).
Among the patients of group II, the «stone free rate» was 115 (88.5%) after the first ESWL session; no infectious and inflammatory complications were observed in the post-procedure period.
Conclusions. The basis for the prevention of infectious and inflammatory complications of extracorporeal shock wave lithotripsy is the constant monitoring of complications and the study of risk factors for their occurrence.
Cancellation of prophylactic antibiotic administration 1 hour before ESWL in patients without urinary tract infection and by exclusion of other risk factors for infectious complications does not lead to the development of post-procedure pyelonephritis and thereby reduces the overall costs associated with the treatment of the patient.
References
WHO methods and data sources for global burden of disease estimates 2000-2016 (Global Health Estimates Technical Report /2018.4) June 2018 http://www.who.int/gho/mortality_burden_disease/en/index.html
Аляев Ю.Г., Глыбочко П.В. Мочекаменная болезнь. Современный взгляд на проблему. Руководство для врачей. 2016г. 148 с.
Arustamov D.L. Nurullayev R.B. Epidemiology of urolithiasis in the Aral Sea Area ecologic disaster zone in Uzbekistan. Urol.Res. -2003. -31, 2. -P. 105
Худайбергенов У.А. Ранняя диагностика и профилактика распространенных урологических заболеваний в условиях первичного звена здравоохранения». Дисс-я д.м.н. 2018г. 179 С.
Taguchi, K., Yasui, T., Milliner, D.S., Hoppe,B., Chi, T. Genetic Risk Factors for idiopathic Urolithiasis: A systematic review of the literature and causal network analysis. //European Urology Focus. https://doi.org/10:1016/j.euf.2017.04.010.
Дзеранов Н.К., Казачснко А.В. Байбрнн К.А. Осложнения открытых оперативных вмешательств, при лечении уролитназа и возможные пути профилактики // Урология. 2002. № 5.- C.34-3S.
Chaussy Ch. Extracorporeal Shock Wave Lithotripsy. Technical Concept. Experimental Research and Clinical Application. New ■ York; Basel: Karger, 1986. -134 p.
Chaussy Ch., Schmtedt E. Extracorporeal shock wave lithotripsy (ESWL) for kidney stones. An alternative to surgery? // Uralogical Radiology, -1984. -Vol. 6. № 2. -P. 80-87.
Skolarikos, A., et al. Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol, 2006. 50: 981. https://pubmed.ncbi.nlm.nih.gov/16481097
Muller-Mattheis, V.G., et al. Bacteremia during extracorporeal shock wave lithotripsy of renal calculi. J Urol, 1991. 146: 733. https://pubmed.ncbi.nlm.nih.gov/1875482
Aeberli D, Müller S, Schmutz R, Schmid HP. Predictive value of radiological criteria for disintegration rates of extracorporeal shock wave lithotripsy. Urol Int. 2001; 66(3): 127-30.
Wiesenthal JD, Ghiculete D, D'A Honey RJ, Pace KT. Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res. 2010 Aug;38(4):307-13. doi: 10.1007/s00240-010-0295-0. Epub 2010 Jul 13.
Lim KH, Jung JH, Kwon JH, Lee YS, Bae J, Cho MC, Lee KS, Lee HW. Can stone density on plain radiography predict the outcome of extracorporeal shockwave lithotripsy for ureteral stones? Korean J Urol. 2015 Jan;56(1):56-62.
doi: 10.4111/kju.2015.56.1.56. Epub 2015 Jan 6
