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ESWL IN HAEMOPHILIACS
Article published in Urologia Polska 1998/51/4.

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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