[Long-term results of endourological treatment with and without ESWL in cystine lithiasis]

From 1984 to 1989, 15 patients with cystine calculi were treated by endourologic procedures and/or extracorporeal shock wave lithotripsy (ESWL). During this period the patients required 38 hospitalizations, a total of 74 calculi were treated localized to 61 sites: pelvic 21, caliceal 13 and 27 were multiple. The diagnosis was confirmed by a 24 hour cystinuria (3.595 muMol/24 h. average) and analysis of the stone fragments. Stone disruption was achieved in 17 of 38 cases (44.7%). ESWL as monotherapy was utilized in calculi less than 15-20 mm. in diameter; complete removal was achieved in of 18 cases. Percutaneous surgery (PC) was used alone or in combination with ESWL for large calculi or when ESWL failed to achieve stone fragmentation. Complete stones removal was achieved in 5 of 9 cases using PC as monotherapy and in 5 of 10 in combination with ESWL. There were 23 recurrences during this period; 13 patients with residual stone fragments and 10 patients that were stone-free. The present study reports our experience in the treatment of cystine calculi by PC and/or ESWL and the long-term results achieved with the respective treatment modalities.