Percutaneous extraction of upper urinary calculi under fluoroscopic control--still a valuable complement to ESWL

Percutaneous extraction of 372 renal and proximal ureteral calculi was performed under fluoroscopic control in 202 consecutive patients. In 193 kidneys (90%) removal of stones was performed under fluoroscopic control only and in 10% initial ultrasonic disintegration was used. A completely stone free kidney was achieved in 74%. If successful outcome is defined as no stones or residual fragments less than 5 mm, the success rate was 91%. With a mean size of 10.3 mm 259 intact stones were extracted under fluoroscopic control. Open surgery was performed in 13 of 202 patients, in 10 of these cases due to unsuccessful removal of an impacted ureteral stone. Complications occurred in 16%, none of them were serious. Open intervention became necessary in 2 patients. Bleeding which required blood transfusion occurred once. Percutaneous renal stone extraction under fluoroscopy is safe and useful in selected patients when ESWL can be expected to produce less favourable results. The ability to perform this technique should therefore be well maintained.