Complications of electrohydraulic lithotresis

The urologic literature reports excellent success with minimal complications utilizing electrohydraulic lithotresis for bladder calculi. Our recent experience with 10 patients suggests that small stones of struvite/carbonate apatite composition can be fragmented easily, but larger stones, particularly of uric acid or oxalate composition, may be better handled by open cystolithotomy. Failure to disrupt stones occurred in 6 patients. Significant complications developed in 3 of these patients, including breakage of the electrode tip in 2 and sepsis in another related to prolonged operative time.