ESWL in hemophiliac patients

Area of Science:

• Urology
• Hematology

Background:

• Urolithiasis poses a risk for patients with bleeding disorders like hemophilia.
• Management of kidney stones in hemophiliacs requires careful consideration of hemorrhagic risks.

Purpose of the Study:

• To evaluate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) for urolithiasis in hemophilia patients.
• To determine the frequency of hemorrhagic complications associated with ESWL in this cohort.
• To establish a treatment protocol for ESWL in hemophiliacs.

Main Methods:

• Eleven hemophilia patients with urolithiasis underwent ESWL between 1991 and 1997.
• Coagulation factor substitution was administered pre-procedure.
• Post-ESWL ultrasound monitored for hemorrhagic complications; withdrawal of substitution was based on clinical status.

Main Results:

• A total of 25 ESWL sessions were performed across the 11 patients.
• Eighty-one point eight percent (9/11) of patients successfully passed their stones.
• No hemorrhagic complications were observed during the study period.

Conclusions:

• Coagulation factor substitution renders ESWL a safe treatment option for urinary stones in hemophilia patients.
• The absence of hemorrhagic complications suggests a favorable safety profile.
• Substitution withdrawal protocols can be guided by patient's clinical recovery and absence of bleeding signs.