ESWL in hemophiliac patients

Objective: To assess ESWL treatment of urolithiasis in patients with hemoph ilia, the frequency of hemorrhagic complications, and to determine the trea tment outline. Patients and Methods: From 1991 to 1997, eleven patients with hemophilia we re treated by ESWL for urolithiasis. Substitution of deficient coagulation factors was started on the day of treatment. Ultrasound examination was per formed in all cases on the 1st day after the procedure in order to discover any potential hemorrhagic complications. Substitution withdrawal depended on the patients' general status, lack of hematuria and the absence of signs of hemorrhage. Preliminary results were evaluated after 7-10 days on the b asis of plain abdominal X-ray of the kidney, ureter and bladder and ultraso nography. Results:: In total, 25 ESWL sessions were performed, 1-6/patient. Nine pati ents (81.8%) discharged stones, and 2 patients are being followed up. No he morrhagic complications were observed. Conclusions: Substitution of deficient coagulation factors makes ESWL a saf e method of urinary stone management in hemophiliacs. No hemorrhagic compli cations were seen in our patients. Substitution withdrawal may be based on the patients' good general status, lack of hematuria and absence of signs o f hemorrhage. Copyright (C) 2000 S. Karger AG. Basel.