Extracorporeal shock wave lithotripsy in paraplegic and quadriplegic patients

As it is known, paraplegic and quadriplegic patients are at an increased risk for urolithiasis. We have studied the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in 15 patients with spinal cord dysfunction who were treated in our ESWL unit. A total of 23 treatments were performed. The number of shock waves ranged between 1500 and 3000 per treatment. Only 1 and 3 patients were stone-free at one-month and 3-month follow-up, respectively. Ten of 15 patients with long-term follow-up of 6 to 20 months were stone-free. The remaining 5 patients with residual fragments had staghorn calculi or stones larger than 2.5 cm. We conclude that ESWL is an effective and well tolerated method for this population but the fragment clearance is delayed and below that for unselected patients.