Explosive nephrolithopaxy: reality or fiction?

The use of silver and lead azide explosive charges for the percutaneous distintegration of renal calculi has been investigated. Charges of 10 mg or more reliably reduced calculi to fragments of extractable size; however, the concomitant tissue effects would preclude the use of such charges clinically. Smaller charges require multiple applications. High-speed flash photography demonstrated the unfocussed nature of these discharges. Considerable improvements are anticipated when the shock waves are focused. The use of Nonel tubing is described, and future developments are discussed.