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Shock wave lithotripsy in solitary functioning kidneys: is prophylactic stenting necessary?
S Kumar1, A Sakthivel, K N Chacko
1Department of Urology, Christian Medical College, Vellore, India. uro2@cmcvellore.ac.in
Objective:
To assess the safety of shock wave lithotripsy (SWL) without prophylactic stents in solitary functioning kidneys.
Patients And Methods:
Sixteen solitary functioning kidneys with 23 renal stones with a size of <15 mm were treated with SWL as the primary modality. All patients were counseled about the possibility of obstruction, and treatment was offered to those who consented. The safety of SWL was assessed by the need for interventions and the posttreatment renal function.
Results:
In 14 patients lithotripsy was uneventful. The duration of treatment ranged from 5 to 35 days. One patient with a 15-mm pelvic calculus presented with anuria which resolved before intervention. In 1 patient fragmentation failed, and percutaneous nephrolithotomy was performed.
Conclusions:
In solitary functioning kidneys, SWL is safe without prophylactic stents in properly selected and closely monitored patients. Avoiding stents decreases costs, duration of treatment, and stent-related morbidity without unduly compromising safety.
