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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
Urologia Internationalis
|August 5, 2006
Summary
Shock wave lithotripsy (SWL) is safe for solitary functioning kidneys without prophylactic stents. This approach reduces treatment time and costs while maintaining patient safety.
Area of Science:
- Urology
- Nephrology
Background:
- Solitary functioning kidneys require careful management during kidney stone treatment.
- Prophylactic ureteral stents are often used with shock wave lithotripsy (SWL) but can cause discomfort and complications.
Purpose of the Study:
- To evaluate the safety and efficacy of SWL without prophylactic stents in patients with solitary functioning kidneys.
- To determine if omitting stents impacts treatment outcomes or patient morbidity.
Main Methods:
- SWL was used as the primary treatment for 23 renal stones (<15 mm) in 16 patients with solitary functioning kidneys.
- Patients were informed of potential obstruction risks and consented to treatment without stents.
- Safety was assessed by monitoring the need for interventions and post-treatment renal function.
Main Results:
- SWL was uneventful in 14 patients, with treatment durations from 5 to 35 days.
- One patient experienced temporary anuria due to a large stone, which resolved spontaneously.
- One case required percutaneous nephrolithotomy due to failed stone fragmentation.
Conclusions:
- SWL is a safe and effective treatment option for solitary functioning kidneys when patients are carefully selected and monitored.
- Omitting prophylactic stents in SWL for solitary kidneys can decrease treatment duration, costs, and stent-related complications without compromising safety.
