Experience with extracorporeal shock-wave lithotripsy (ESWL) for urinary calculi

Over a 36-month period 2800 patients were subjected to extracorporeal shock-wave lithotripsy (ESWL). A total of 5154 procedures were done. Best results were seen with renal pelvic calculi (not larger than 2.5 cm in diameter). Fragments of crushed lower calyceal calculi proved the most difficult to eliminate. As ureteral stone localization approached the bladder, the ESWL results were poorer. Post-ESWL complications were proportional to the stone mass; the higher the mass the more numerous the complications tended to be. Besides erythrocyturia and gross haematuria renal colic was the most frequent complication in almost 60% of the patients. Less prevalent were impacted ureteral stones, subcapsular haematoma and fever. At our institution, thanks to the ESWL method about 80% of the patients were spared surgery.