Nonorganic (functional)‎ abdominal pain in children

Abstract EN

Objective : to compare the outcome of extracorporeal shock wave lithotripsy for renal stones with and without double J stent.

Patients and Methods: A comparative cross sectional study was carried out at the urological department of Al-Hilla teaching hospital from February 2011 to August 2011.

Forty patients with renal stones measuring from (2cm_2.5cm) were selected for the treatment by extracorporeal shock wave lithotripsy (ESWL).

All of these patients were adults with normal renal function and had unilateral radiopaque renal stones, no metabolic abnormalities, no symptomatic urinary tract infection.

Children, renal failure and patients with lower caliceal stones were excluded from the study.

They were divided in two groups of 20 each.

Group A patients underwent ESWL without a double J stent and in group B a double J stent was placed before ESWL.

Electrohydraulic lithotripter machine (PCK lithotripter, Turkey), was used to impart shock wave.

2000 shock wave were given in a session.

Both the groups were compared for stone fragmentation, incomplete stone clearance, clinically insignificant stone fragment, steinstrasse, stone free rate, renal colic, fever, hemmaturia, dysuria, and number of ESWL session.

Result : regarding stone fragmentation in group A (stentless), 19 patients had stone fragmentation from total number of patients of 20 which account 95 % while in group B (stented), 18 patients develops stone fragmentation from total number of patients of 20 which account 90 %.

Incomplete stone clearance occurs in 4 (20 %) patients without DJS and in 8 (40 %) patients with DJS.

Clinically insignificant stone fragments encounter in 3 (15 %) patients in stentless group and also in 3 (15 %) in stented group.

Steinstrasse developed in 1 (5 %) patient without DJS and none in patients with DJS.

Stone free rate encounter in 11 (55 %) patients in stentless group and 7 (35 %) patients in stented group.

Renal colic developed in 9 (45 %) patients without DJS and in 3 (15 %) patients with DJS.

Hemmaturia encounter in 12 (60 %) patients without DJS and in 15 (75 %) with DJS.

Fever not encountered in patients without DJS and developed in 15 (75 %) patients with DJS.

Frequency developed in 2 (10 %) patients without DJS and in 10 (50 %) patients with DJS, while dysuria developed in 3 (15 %) patients without DJS and in 10 (50 %) patients with DJS Conclusion: pre ESWL double J stenting for 2-2.5 cm renal stone was not beneficial regarding stone fragmentation, stone clearance, steinstrasse and stone free rate, however renal colic was significantly less in stented group.

Fever and lower urinary tract symptoms (LUTS) was significantly higher in stented patients.