[Extracorporeal lithotripsy by shock waves. Initial results (322 cases)]

Results of 322 patients treated with extracorporeal shock wave desintegration are reported (277 patients treated with the Dornier lithotripter, 45 patients treated with Solonithe using ultrasonic stone location). Lesions treated included 168 caliceal, 111 pyelic, 23 ureteral and 21 coralliform calculi. 45 patients presented multiple and 28 bilateral renal lithiasis. Stones were mainly between 10 and 20 mm in diameter (157 patients) but were less than 10 mm in size in 110 cases and more than 20 mm in 55. For poorly opaque stone, lithotripsy was performed after ultrasound localization with the Sonolithe apparatus. The Dornier machine was used to treat 277 patients during 308 sessions, equivalent to an 11% repeat rate. Fragmentation was excellent in 84% of cases after a single session, and 5% of stones could not be fragmented and required complementary therapy. Out of 200 patients reviewed after 3 months, only 8% had residual fragments (92% success rate), 5% having to undergo auxillary endoscopic manoeuvres: stenting ureteral catheter (4 cases); percutaneous nepholithotomy (3 cases); ureteroscopy (7 cases). Septic complications (6 patients) responded well to antibiotic treatment. Renal colic or pain was recorded in 25% of cases. One kidney was non-functional at 3 months due to distal ureteral obstruction without subsequent dilatation of the collecting system. Out of 45 patients treated with the Sonolithe, 3 (6.6%) were failures of fragmentation and 85% had satisfactory results. After a minimum follow up of 3 months, 20/22 patients were free of residual calculi, and there were no complications.(ABSTRACT TRUNCATED AT 250 WORDS)