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Solitary kidney stone treatment by extracorporeal shock wave lithotripsy
A Vuksanovic1, S Micic, V Petronic
1Clinic of Urology, University Clinical Center, Belgrade, Yugoslavia.
Objectives:
To determine if solitary kidney stones can be successfully treated with ESWL.
Methods:
38 patients were examined, 34 stones were treated on a Dornier lithotripter HM-3, and 4 on a Siemens Lithostar. 17 stones were larger than 400 mm2, 11 were incomplete and 6 complete staghorn calculi. In 26 patients a catheter was placed before lithotripsy, double-J and ureteral stents in 14 and 12, respectively.
Results:
Successful outcome of lithotripsy was achieved in 34 patients (89%). Complete fragment elimination was recorded in 23 patients (60%), and in 11 (29%) a negligible residuum was noticed. Treatment failure was recorded in 4 patients. In 3 patients fragment elimination was poor, and in 1 patient 3 ESWL sessions were not sufficient to commence stone destruction and we decided to operate on this patient. Anuria occurred in 4 patients (10%).
Conclusions:
Our results suggest that ESWL can be successfully used in the treatment of urolithiasis in a solitary kidney. Even in cases of staghorn stones, the obligatory placement of a double-J catheter, and strategic lithotripsy in several sessions result in a high success rate with a tolerable risk of complications.