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Related Experiment Videos

Stone treatment and coagulopathy.

H C Klingler1, G Kramer, M Lodde

  • 1Department of Urology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. cklinger24@hotmail.com

European Urology
|January 1, 2003
PubMed
Summary

Patients with clotting disorders undergoing upper tract stone treatment experienced higher complication rates and prolonged hospital stays. Endoscopic procedures are favored over extracorporeal shock wave lithotripsy (ESWL) for stone removal in this group.

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Area of Science:

  • Urology
  • Nephrology
  • Hematology

Background:

  • Systemic clotting disorders or anticoagulation present unique challenges for urologic stone interventions.
  • Effective management strategies are crucial to minimize risks in these patients.

Purpose of the Study:

  • To evaluate treatment protocols and outcomes for upper tract stones in patients with clotting disorders.
  • To compare the efficacy and safety of different stone removal techniques in this specific population.

Main Methods:

  • Retrospective analysis of 76 stone interventions in 35 patients with clotting disorders over a 6-year period.
  • Interventions included extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL).
  • Clotting disorders were corrected prior to procedures; outcomes and complications were recorded.

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Main Results:

  • Overall complication rate was 13.1% (10/76).
  • ESWL showed lower success (88.9%) and higher complication (33.3%) rates compared to URS (100% success, 0% complications) and PNL (100% success, 33% complications).
  • Stone clearance time was longer with ESWL in coagulopathic patients; URS costs were higher but less pronounced than ESWL.

Conclusions:

  • Patients with coagulopathy face increased complication risks and prolonged hospitalization for upper tract stone treatment.
  • Extracorporeal shock wave lithotripsy (ESWL) efficacy is reduced in patients with coagulopathy.
  • Endoscopic procedures (URS, PNL) are preferred for stone removal in patients with clotting disorders due to better outcomes and safety profiles.