Long-term followup in 1,003 extracorporeal shock wave lithotripsy patients

We evaluated 1,003 patients treated with extracorporeal shock wave lithotripsy after a mean followup of 19.1 months (range 12 to 26 months). Followup excretory urograms were normal in 97 per cent of the patients. Two-thirds of the patients reported further discharge of residual fragments, mainly during the first 3 months. Rehospitalization was necessary in 57 patients. Over-all, the rate free of stones after followup was 72.2 per cent and it was not different for primary and recurrent stone patients. Rates free of stones were influenced mainly by the primary stone location and the number of stones in a renal unit. Patients with lower caliceal stones had a rate without calculi of only 57.8 per cent. Almost identical results were obtained for stones other than in the lower calix, when fragments were found in the lower calix at the time the patient was discharged from the hospital. The pre-treatment stone volume, as determined by measuring the stone area in square millimeters, did not influence the final rates free of stones for calculi up to 400 mm.2, that is 2.4 cm. of a sphere. Only calculi larger than 400 mm.2 showed an inverse relationship to the final rate free of stones. Multiple stones yielded a success rate of 64 per cent, with 90 per cent of the patients having regrowth of residual fragments. Serious complications during followup were not encountered.