ESWL in hemophiliac patients

To assess ESWL treatment of urolithiasis in patients with hemophilia, the frequency of hemorrhagic complications, and to determine the treatment outline.

From 1991 to 1997, eleven patients with hemophilia were treated by ESWL for urolithiasis. Substitution of deficient coagulation factors was started on the day of treatment. Ultrasound examination was performed in all cases on the 1st day after the procedure in order to discover any potential hemorrhagic complications. Substitution withdrawal depended on the patients' general status, lack of hematuria and the absence of signs of hemorrhage. Preliminary results were evaluated after 7-10 days on the basis of plain abdominal X-ray of the kidney, ureter and bladder and ultrasonography.

In total, 25 ESWL sessions were performed, 1-6/patient. Nine patients (81.8%) discharged stones, and 2 patients are being followed up. No hemorrhagic complications were observed.

Substitution of deficient coagulation factors makes ESWL a safe method of urinary stone management in hemophiliacs. No hemorrhagic complications were seen in our patients. Substitution withdrawal may be based on the patients' good general status, lack of hematuria and absence of signs of hemorrhage.