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[Controversies on extracorporeal shockwave lithotripsy]
Archivos Espanoles De Urologia
|January 1, 1989
Summary
Extracorporeal shock wave lithotripsy (ESWL) effectively treated 3,000 patients, achieving stone-free rates of 83.2%. However, ESWL may be less suitable for specific kidney anomalies, stone types, and patient conditions.
Area of Science:
- Urology
- Nephrology
- Medical Technology
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for kidney stones.
- Assessing the efficacy and limitations of ESWL in a large patient cohort is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the outcomes of ESWL in 3,000 patients with urinary calculi.
- To identify patient groups and stone characteristics where ESWL indication might be questionable.
Main Methods:
- Retrospective analysis of 3,000 patients undergoing ESWL.
- Data collection on patient demographics, stone characteristics (size, type), and treatment outcomes.
- Categorization of outcomes including stone-free status, spontaneous fragment passage, and need for secondary surgery.
Main Results:
- Overall stone-free rate was 83.2% with 13.1% experiencing spontaneous fragment passage.
- Success rates varied based on stone size and type, with staghorn calculi comprising 23% of cases.
- ESWL efficacy was questioned in patients with renal anomalies, specific stone compositions (e.g., cystine), and certain patient conditions (e.g., solitary kidneys, paraplegia).
Conclusions:
- ESWL is a highly effective treatment for a broad range of kidney stones.
- Careful patient selection is recommended, considering renal anomalies, stone complexity, and specific patient comorbidities for optimal ESWL outcomes.