ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.

9. EFFECTS OF TRANSIENT POST ESWL OBSTRUCTION ON RENAL FUNCTION.

Hossam M. Gad., Khaled Z. Sheir, Khaled Madbouly, Emad El-Sobky and Mohamed A. Ghoneim.
Institutions: Urology & Nephrology Centre -Mansoura University Mansoura -Egypt.

INTRODUCTION AND OBJECTIVES: This study examined the effects of transient post SWL obstruction on renal function after its application for treatment of renal stones in one non-obstructed kidney, using two different lithotripters.

METHOD: This study included one hundred consecutive patients with unilateral renal stones were treated by SWL monotherapy in our center. The patients had normal laboratory profile in terms of renal function, liver function, blood picture, bleeding and clotting time, prothrombin concentration, and no or controlled urinary tract infection. Also, the urinary tract was radiologically normal with no obstruction. 99mTechnetium mercaptoacetyltriglycine (99mTc-MAG3) and 99mTechnetium dimercaptosuccinic acid (99mTc-DMSA) renographic studies together with Doppler sonography were performed for all cases few days before, one week after and three months after SWL. Renal uptake, Tmax, split renal function, ERPF and detection of renal scarring can be obtained from renographic studies as well as resistive index which can be calculated using Doppler sonography. Patients were stratified into 2 groups; Group I).
Patients with non obstructed kidneys after SWL (N = 84), Group II) Patients with obstructed kidneys one week after SWL. (N = 16).

RESULTS: In group I, we found slight but statistically significant improvement of renal function. In group II, a significant deterioration of ipsilateral renal function was observed one week after SWL. This was due to transient obstruction by steinstrasse. This improved after 3 months, but still below the pre SWL baseline function. DMSA scan revealed no changes after 3 months in both groups. Furthermore, there were no significant changes of the resistive index in both groups.

CONCLUSION: Post SWL obstruction although transient has a major effect on the renal function on the treated side and must be managed urgently. On the other hand, SWL of renal stones in normal kidneys, with no post treatment obstruction, has no deleterious effect on the renal function.