CONTENTS FROM THE ABSTRACT IF USICON-99"
OUR EXPERIENCE WITH ESWL AS MONOTHERAPY IN STAGHORN CALCULUS IN INDIA STEP
Dr. Meena Jain, Dr. Tondon J.K.DEPARTMENT OF UROLOGY ROYALE HOSPITAL & RESEARCH CENTRE, JABALPURINTRODUCTION:
ESWL is one of the major advances of medical fraternity of recent times. Since the first ESWL therapy in 1980, it is making rapid advances and has almost replaced open surgery and to a great extent PCNL also. The indications have broadened to include multiple as well as stag-horn calculi due to advancement in the lithotripter machine.
MATERIAL& METHODS:
We are using an Indian made Lithotripter Vulcan VL-10 which incorporates 3rd generation generator. This has better disintegration and clearance because it breaks to almost sand like particles. We present our experience in 36 stag-horn calculi patients. The main advantage of this lithotripter is that it does not require even sedatives. In very apprehensive patients, an injection of Diclofenac sodium suffices and the patient goes home the same day. Many of them even do not need DJ stenting. It was used in 6 cases only. Steinstrasse occurred in01 patient, which cleared after DJ stenting. Number of shocks varied from 1400 to 3500 in one sitting. Later on depending upon the bulk left, shockwaves were used, which never exceeded total of 8000 without any morbidity.
RESULTS:
Out of 36 patients, 32 had completed disintegration, 2 had partially and 2 did not disintegrate.
ROYALE HOSPITAL AND RESEARCH CENTREDr. J.K. Tondon
M.B.B.S., M.S., M.ch. (Urology)
Dr. Meena Jain
M.B.B.S., M.S. (Surgery)
We purchased Vulcan VL-10 Lithotripter more than 2 years back mainly because of its price factor. Now we realized that it is not only price but fragmentation of stones is also very good. Even harder and stag-horn stones can be treated if proper selection is made. Now we have a series of 36 cases of Stag-horn calculi treated with this machine with more than 93% clearance rate. The machine is extremely comfortable to patients as well.