Extracorporeal lithotripsy in patients with hemophilia: systematic review.

Sallami, Sataa; Baccouche, Hela; Mahjoub, Sonia; Ben Romdhane, Neila

BACKGROUND: The management of urolithiasis in patients with haemophilia poses a real challenge to the urologist. AIM: We conducted a systematic literature review to assess the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of urolithiasis in hemophiliacs. METHODS: A systematic review was conducted by using the National Library of Medicine (PubMed) search engine between January 1985 and June 2013. We've used these key words: "haemophilia" and "extracorporeal shock wave lithotripsy". All articles dealing with the treatment of nephrolithiasis by ESWL in patients with hemophilia were included. Two independent reviewers extracted the data from each article. The data was included into a systematic review and analyzed. RESULTS: A total of 12 medical articles were selected with a total of 25 patients. The stone size varies from 6 to 21 mm. The substitution of the deficient clotting factor started the day before the ESWL. ESWL was effective in all patients except one after 1-6 sessions / patient. An ultrasound was performed after the procedure to look for potential bleeding complications. The judgment of the substitution therapy depends on the patient's condition, the presence of hematuria and the absence of signs of bleeding. Major bleeding complications were observed in 4 patients. CONCLUSIONS: With effective substitution of deficient clotting factors, ESWL is a safe and low morbidity method in the treatment of urinary calculi in hemophiliacs.