ÜRİNER SİSTEM TAŞ HASTALIĞI NEDENİYLE EKSTRAKORPOREAL ŞOK DALGA LİTOTRİPSİ (ESWL) UYGULANAN HASTALARDA AĞRININ TEDAVİ BAŞARISI ÜZERİNE ETKİSİ

Giriş: Çalışmamızda ekstrakorporeal şok dalga litotripsi (ESWL) işlemi sırasında vizüel ağrı skoru (VAS) ile değerlendirilen ağrı skorunun böbrek taşı tanısı alan hastalarda uygulanan ESWL başarısına etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışma Ocak 2020- Ocak 2022 tarihleri arasında üst üriner sistem taşı tanısı konulan ve bu sebeple ilk defa ESWL tedavisi alan 160 hastanın verileri retrospektif incelenerek gerçekleştirildi. Hastaların demografik özellikleri, radyolojik görüntülemede üriner sistem taşının özellikleri ve işlem esnasında kaydedilen vizüel ağrı skorları kaydedildi. Hastalar ESWL tedavisi sonrası yapılan kontrollerinde taşsızlık sağlanan ve rezidü taş izlenen hastalar olmak üzere iki gruba ayrılarak gruplar istatistiksel olarak karşılaştırıldı. Bulgular: 101 (%63.1) hastada ESWL tedavisi ile taşsızlık sağlandı. ESWL tedavisinin başarı oranı %63.1 olarak hesaplandı. Hastaların sırasıyla ortalama taş boyutu, taş-cilt mesafesi ve taş yoğunluğu; 11.41±3.79 mm, 108.12±19.48 mm ve 1024.51±322.59 Hounsfield Unit (HU) olarak hesaplandı. Ortalama VAS ise 5.22±2.64 idi. Lojistik regresyon analizi sonucunda ESWL başarısında taş boyutu ve ağrı skorunun bağımsız risk faktörleri olduğu görüldü. Sonuç: ESWL üriner sistem taşlarının tedavisinde etkili bir yöntemdir. Taş boyutunun artması ve işlem sırasında izlenen yüksek VAS’nun ESWL başarısında rol oynayan en önemli risk faktörleri olduğunu ortaya koyduk. ESWL esnasında başarılı ağrı kontrolü ile tedavi başarı oranının artacağını düşünmekteyiz.

THE EFFECT OF PAIN ON THE SUCCESS OF TREATMENT IN PATIENTS WHO PERFORMED EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) DUE TO URINARY SYSTEM STONE DISEASE

Introduction: In our study, we aimed to evaluate the effect of pain score which was evaluated with visual pain score (VAS) during the extracorporeal shock wave lithotripsy (ESWL) procedure on the success of ESWL that was applied for the patients diagnosed with kidney stones. Material and Method: The study was carried out by retrospectively examining the data of 160 patients who were diagnosed with upper urinary tract stones and therefore received ESWL treatment for the first time between January 2020 and January 2022. The demographic characteristics of the patients, the characteristics of the urinary tract stone in the radiological imaging, and the visual pain scales recorded during the procedure were recorded. The patients were divided into two groups as stone-free and those with residual stones in the controls after ESWL treatment, and the groups were compared statistically. Results: Stone-free statue after ESWL treatment was achieved in 101 (63.1%) patients. The success rate of ESWL treatment was calculated as 63.1%. Mean stone size, stone-skin distance and stone density of the patients were calculated as 11.41±3.79 mm, 108.12±19.48 mm and 1024.51±322.59 Hounsfield Unit (HU), respectively. The mean VAS was 5.22±2.64. As a result of logistic regression analysis, stone size and pain score were found to be independent risk factors for ESWL success. Conclusion: ESWL is an effective method in the treatment of urinary system stones. We revealed that increased stone size and high VAS observed during the procedure are the most important risk factors that play a role in the success of ESWL. We think that the treatment success rate will increase with successful pain control during ESWL.

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