[Extracorporeal shock wave lithotripsy in a patient with hemophilia B]

We report a successful treatment of extracorporeal shock wave lithotripsy (ESWL) on a renal stone in a patient with severe hemophilia B. The patient was 44 years old man who had suffered left flank colicky pain with gross hematuria. A radiographic study showed a left renal stone, 22 x 14 mm in size. Before treatment, the intravenous administration of 1,000 U of the missing factor IX was tried, which induced the recovery of the prothrombin and partial thromboplastin times to the normal levels. One thousand units of factor IX were infused 30 minute before ESWL and 2,363 shock waves (Dornier MPL-9000) were administered at 17 kV under intravenous anesthesia by pentazocine. After the treatment, ultrasound and CT did not detect any perirenal hematoma. Antihemophilic therapy was continued with 1,000 U of factor IX per 12 hours for 2 days, 1,000 U per 24 hours for the succeeding 8 days and 500 U per 24 hours for the last 7 days. Gross hematuria disappeared on the 3rd day. We could successfully treat a renal stone in a patient with hemophilia.