[ESWL with the Lithostar--experience with 3,000 treatments]

Area of Science:

• Urology
• Nephrology
• Surgical Technology

Background:

• Kidney and ureteral stones (calculi) affect a significant portion of the population.
• Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment option for calculi.
• The Lithostar device has been utilized for ESWL procedures.

Purpose of the Study:

• To report experiences with 3,000 extracorporeal shock wave lithotripsies (ESWL) of kidney and ureteral calculi.
• To review indications, contraindications, and therapeutic approaches for ESWL.
• To emphasize the importance of outpatient follow-up after ESWL.

Main Methods:

• Retrospective analysis of 3,000 ESWL procedures performed using the Lithostar device.
• Review of patient data including indications, treatment outcomes, and follow-up.
• Comparison of procedural outcomes between the initial period and the later stages of the study.

Main Results:

• A success rate of 75% was achieved, including spontaneous passage of residual fragments.
• A second ESWL treatment was sometimes necessary for complete stone clearance.
• The need for percutaneous nephrolitholapaxy or open surgery decreased significantly over time, from 6% to 0% in the last 100 patients.

Conclusions:

• ESWL using the Lithostar is an effective treatment for kidney and ureteral calculi, even in an unselected patient population.
• Careful patient selection and follow-up are crucial for optimizing ESWL outcomes.
• Advancements in ESWL protocols have reduced the requirement for more invasive surgical interventions.