Evaluation of Hematological Parameters After ESWL and Ureterorenoscopy for the Treatment of Kidney Stones

Background: Bleeding and hematuria can be a consequence of both ESWL and URS treatment.Changes in hematological parameters may be indicative of bleeding events.Objective: The aim of the present study was to explore the hematological parameters after ESWL and ureterorenoscopy for the treatment of kidney stones. Methods: A prospective study included patients (120) with verified ureterolithiasis <10 mm in the upper half of the proximal third of the ureter. Patients were divided into two groups using the random sample method for the application of active stone removal methods ESWL or URS with contact disintegration.Patients were evaluated with routine hematological, biochemical blood parameters, and non-contrast enhanced computed abdominal tomography (CT) before the procedure.Routine laboratory analyzes were performed using standard methods and included determination of the number of erythrocytes, platelets, hemoglobin, hematocrit, glucose, INR, APTTwhich were measured preintervention, the first postoperative day and six months after the intervention. Results: The preintervention hemoglobin value in patients with urolithiasis treated with URS treatment was 140 g/L (136.2–155.7), and was statistically significantly higher compared to the measurement on the first post-intervention day [137.5 g/L (127, 2–156.7) (p<0,05)], as well as in relation to the measurement after six months [139 g/L (134.2–151.7), (p<0,05).The pre-interventional hematocrit value in patients with urolithiasis treated with URS treatment was 0.42 (0.41–0.47), but it dropped statistically significantly on the measurement on the first post-intervention day to a value of 0.41 (0.38–0, 47) (p=0.003). The hematocrit value after six months was 0.44 (0.41–0.47) and was statistically significantly higher compared to the pre-intervention measurement (p=0.002), as well as compared to the measurement on the first post-intervention day (p< 0.001). The pre-intervention INR value in patients with urolithiasis treated with URS treatment was 0.90 (0.86–1.1), and on the first post-intervention day, it increased statistically significantly to a value of 0.99 (0.89–1.1), (p=0.005).The INR value after six months continued to grow to a value of 1.02 (0.96–1.2), which was statistically significantly higher compared to the INR value measured on the first post-intervention day (p<0.001), as and in relation to the INR value measured before the intervention (p=0.007).Conclusion: The results of this study, in terms of hematological parameters, showed more favorable outcomes in patients treated with ESWL compared to URS lithotripsy. Significantly lower hemoglobin values six months after URS treatment, as well as a decrease in the number of platelets on the first postoperative day, lead to the conclusion that URS lithotripsy, which represents a more aggressive method compared to ESWL, may have less favorable consequences for patients.