Silent obstruction after extracorporeal piezoelectric lithotripsy

Extracorporeal piezoelectric lithotripsy (EPL) is frequently used to treat renal calculi. We are presenting a case that developed silent ureteric obstruction following three sessions of EPL of 4,000 shocks each. The obstruction was silent and asymptomatic, and was detected 6 weeks later on a routine follow-up renogram. The obstruction was due to an impacted stone fragment in the lower ureter. After release of the obstruction, the kidney function did not return to pre-therapy levels due to irreversible damage. This case demonstrates the importance of doing renograms before and within a few days after shock therapy for renal stones.