Extracorporeal shock wave lithotripsy for ureteral stones: do decompression tubes matter?

Extracorporeal shock-wave lithotripsy (SWL) offers an effective and minimally invasive method for treating ureteral stones. In the current study we investigated whether the presence of a double-J (JJ) stent or a percutaneous nephrostomy (PCN) has any impact on the SWL success rates for ureteral stones.

All adult patients with ureteral stones treated with the second-generation Siemens Lithostar® Multiline (Siemens, Erlangen, Germany) lithotriptor between 2002 and 2007 were included. Exclusion criteria comprised radiolucent or nonsolitary stones, calculi >10 mm in diameter in the lower ureter, stones that were pushed back into the kidney during JJ stent insertion and patients who had undergone stent or nephrostomy tube insertion after initiation of SWL therapy, though having started treatment as "tubeless." In total, 342 individuals were divided into 3 groups: group I (n = 56) consisted of patients with a PCN; group II (n = 73) included patients with a JJ stent; and group III (n = 213) comprised individuals without any decompression tubes. All patients were reviewed in the outpatient clinic.

The mean age for all patients was 50.1 years (range 16-90 years) and the mean ureteral stone size was 9.4 mm (SD = 3.6 mm). Successful stone clearance was achieved in 60.7%, 47.9%, and 59.2% of the 3 groups, respectively. There was no statistically significant difference in success rates between the aforementioned groups.

The results of the current study suggest that the presence of either a PCN or a JJ uretral stent does not exert any influence on stone clearance after SWL treatment.