Urinary stone characteristics of patients treated with extracorporeal shock wave lithotripsy in Cipto Mangunkusumo Hospital Jakarta, 2008–2014: a gender analysis

Background: The incidence of urinary stone patient in Indonesia has increased every year in both genders. Data showed that urolithiasis was higher in male rather than female. The aimed of this study was to describe the characteristics of urinary stone found in patient who underwent extracorporeal shock wave lithotripsy (ESWL) at Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. Methods: Data obtained from ESWL medical record Cipto Mangunkusumo Hospital, Jakarta from 2008–2014. We obtained 5,174 out of 6,020 data due to incompleteness data record. We sorted data records by gender, age, stone location, stone opacity, size of the stone, and history of ESWL, and analyzed by statistic tools (SPSS v 20 for Mac). Results: From 5,174 records, we found that the incidence of urinary stones was two times higher in male rather than female (66.3%:33.64%), occurred mostly in productive age (65.2% male, 65.9% female). Unilateral kidney stone was most common location found for both gender (50.2% male, 57.2% female), and most frequent site located in calyx inferior (24.8% male, 28.9% female). About 72.9% stone was radiopaque (73.7% male and 71.5% female). The mean size of the stone in male and female was 11.34±7.15 mm and 11.90±7.54 mm, respectively. This study also showed that 79.3% patients came for first ESWL. Conclusion: Urinary stone founds two times higher in male than female, and mostly occurs on their productive ages. Unilateral kidney stone in calyx inferior become the most common stone found in both gender. Most of the stone has radiopaque opacity

Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study [version 1; referees: 1 approved, 2 approved with reservations]

Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL). Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice.   Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL).   Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037). Our results revealed that TBL (mL) = -153.379 + 0.229 × stone burden (mm2) + 0.203 x baseline serum hematocrit (%); thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL