ABSTRACT
Objectives: in the present study, we evaluate prospectively the efficacy and safety of emergency ESWL [eESWL] in the management of acute renal colic with obstructing ureteric calculi. That is resistant to medical treatment
Patients and Methods: the study involved 220 patients presented by acute renal colic due to obstructing ureteral stones. Of whom 190 patients. [155 men and 35 women] complete the follow-up period. The mean age of these patients was 37 years range between 18-67 years. Stones are
Results: pain completely resolved After ESWL in 70% of the patients, additional medical treatment in 24% and persistent in 6%. On average the pain decrease by 75% after ESWZ according to visual pain scale reference. The rate of recurrence of the acute renal colic decreased significantly after ESWL [P= 0.01]. ESWL decreased the complication rate of acute obstructing stones by almost 50% and the average hospital stay by 2.6 days. The overall rate of successful stone clearance after ESWL was 85% [range 80% to 88.8%]. The overall rate of spontaneous stone passage after medical treatment was 66.3% [range 17.6% to 94%]. For distal ureteral stones =/>5mm there was no significant difference in the stone clearance and the hospital stay between the 2 groups [94% Vs 86.6%. and 1.1 Vs 1.3 days, for group 1 and 2, respectively]
Conclusion: emergency ESWL is a suitable alternative treatment for persistent acute renal colic secondary to obstructive ureteral stones. It resolves the pain in most of the patients and decreases the hospital stay and the complication rate. However, it is not a suitable treatment modality for distal ureteral stone 55 mm unless it is done for severe and persistent pain