Background: The incidence of upper tract urolithiasis is rising worldwide and treatment options have improved to include extracorporeal shock-wave lithotripsy (ESWL), percutaneous nephrolitothomy (PCNL) and ureterorenoscopy (URS) but sub- Saharan Africa has lagged behind the rest of the world. Open stone surgery was the main surgical treatment for upper tract stones in Kumasi until the introduction of ESWL five years ago. This study was conducted to evaluate ESWL in the management of upper tract urolithiasis in Kumasi, Ghana.
Materials and methods: We prospectively analyzed all patients treated for upper tract urolithiasis at the Bomso Specialist Hospital in Kumasi from January 1, 2014, to December 31, 2017. Patients with upper tract stone of 2cm or less underwent ESWL. Data was obtained on patient demographics, stone characteristics, outcome of ESWL and analyzed with PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.
Results: There were 170 patients with upper tract urinary stones over the study period with a male: female ratio of 2:1. The mean age was 46.5 years. Inadequate fluid intake (<3L/day) was the most common predisposing factor, seen in 45.3% of the patients and the commonest symptom was flank pain, seen in 134 (78.8%) patients. There were 149 (87.6%) patients with solitary stones, mostly in the kidney 115 (67.6%). A total of 142 (83.5%) patients underwent ESWL with successful stone clearance in 120 patients. The most common complication of ESWL was flank pain 36 (25.4%).
Conclusions:ESWL is effective for treatment of upper tract urolithiasis and should be available to selected patients in sub- Saharan Africa.