authors
-
Maciej Czaplicki 1, Tomasz Jakubczyk 1, Andrzej Borkowski 1, Wojciech Ja¶kowiak 2, Jan M. Ziemski 2
- 1 Katedra i Klinika Urologii AM w Warszawie
Kierownik Kliniki: prof. dr hab. med. A. Borkowski
2 Klinika Chirurgiczna Instytutu Hematologii i Transfuzjologii w Warszawie
Kierownik Kliniki: prof. dr hab. med. J. M. Ziemski
keywords
-
urinary tract urolithiasis ESWL haemophilia
summary
- Objective. ESWL is said to be contraindicated in patients with just diagno-
- sed or resistant to treatment coagulopathies. One of them is haemophilia
- ? the deficiency of VIII (haemophilia A) or IX (haemophilia B) clotting
- factors. The assessment of ESWL treatment in patients with haemophilia,
- fre±uency of haemorrhagic complications and determination of treatment al-
- gorithm were the aim of the study.
- Material and methods. From 1991 to 1997 11 patients with haemophilia
- were treated by ESWL due to urolithiasis. Substitution of lacking clotting
- factors was started on the day of the treatment. In all of the cases on the lst
- day after the treatment ultrasonography was performed in order to diagno-
- se haemorrhagic complications. Substitution withdrawal depended on patients'
- general status, lack of haematuria and signs of haemorrhagia in laboratory tests
- and ultrasonography. Preliminary results were evaluated after 7-10 days on the
- basis of KUB and ultrasonography.
- Results. The total number of 25 ESWL treatment were performed, 1-6 per single
- patient. In 9 patients (81.8%) stones were discharged, 2 patients are being followed
- up. No haemorrhagic complications in laboratory tests and ultrasonography were
- found.
- Conclusions. Substitution of lacking clotting factors makes the ESWL a safe
- method of urinary stones management in haemophiliacs and therefore it
- should be regarded as a method of choice. No haemorrhagic complications
- were found in our patients. Substitution withdrawal may be based on patients'
- general status, lack of haematuria and signs of haemorrhagia. During pre-
- and postreatment period haematologic care shoud be ensured.
references
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