TO DETERMINE THE EFFICACY OF INTRAVENOUS HYDRATION ALONG WITH DIURESIS AND LIMITED INVERSION DURING ESWL IN PATIENTS WITH LOWER POLE STONES AT SIUT

Introduction: The incidence of urolithiasis increases significantly in stone belt areas like Indo-Pak. Extracorporeal shock wave lithotripsy (ESWL) is recognized as safe procedure that carries an important role in managing upper tract stones. Aim of study is to determine the efficacy of intravenous hydration along with diuresis and limited inversion during ESWL in patients with lower pole stones which causes good fragmentation and better clearance of stone.

Methods: This was a descriptive case series study, included 215 adult patients having single lower calyceal stones ≤ 2 cm on x-ray and ultrasound conducted in Sindh Institute of Urology & Transplantation (SIUT) from 23 January 2018.to 22nd July 2018. ESWL was supplemented by 1 Liter intravenous hydration started 5 minutes before the procedure, diuresis with intravenous Injection Furosemide 40mg 5 minutes before procedure and inversion of operating table to 20 degree. Final outcome i.e. in terms of efficacy was assessed after 3 months. All the demographic information was entered in pre-designed Performa.

Results: - The average age of the patients was 33.47±9.95 years. Efficacy of intravenous hydration along with diuresis and limited inversion during ESWL in patients with lower pole stones was 86.51% (186/215)

Conclusion:  ESWL treatment is still being preferred as a noninvasive and successful method in the treatment of lower pole stones and with I/V hydration cause good clearance of lower pole stone fragments

Key Words: Extracorporeal shock wave lithotripsy, Urolithiasis, Intravenous hydration, Lower pole stones