[Extracorporeal shockwave lithotripsy in single kidneys. Our experience]

Area of Science:

• Urology
• Nephrology
• Surgical Technology

Background:

• Renal lithiasis in a single kidney presents unique management challenges.
• Urinary obstruction and anuria necessitate prompt intervention.
• Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment option.

Purpose of the Study:

• To evaluate the efficacy and safety of ESWL for renal lithiasis in patients with a solitary kidney.
• To assess the impact of urinary bypass procedures on ESWL outcomes.
• To determine the long-term renal function following ESWL in this patient cohort.

Main Methods:

• Forty patients with single-kidney renal lithiasis underwent ESWL.
• Urinary bypass or double-J catheterization was performed in select cases.
• Treatment was primarily ambulatory with analgesia.
• Follow-up included assessment of stone-free status and renal function at 6 months.

Main Results:

• 60% of patients achieved a stone-free status after ESWL.
• 30% had residual debris, and 10% experienced treatment failure (fragmented or non-fragmented).
• Renal function remained stable, with transient obstructive uropathy in 2 patients.
• No significant difference in outcomes was observed for calculi <10 mm with or without double-J catheterization.

Conclusions:

• ESWL is an effective and safe treatment for single-kidney renal lithiasis.
• Ambulatory ESWL is feasible with low morbidity.
• Urinary bypass may not be necessary for all patients, including those with smaller calculi (<10 mm).