Extracorporeal Shock Wave Lithotripsy of Radiolucent Urinary Calculi Using the Dornier HM-3 and HM-4 Lithotriptors

Abstract

Between September 1992 and June 1995, 33 patients with radiolucent urinary calculi were treated in our hospital using Dornier HM-3 and HM-4 lithotriptors. There were 11 caliceal stones, 13 in the renal pelvis, and 9 in the ureter. Stone localization was achieved in only 30 patients using intravenous urography or retrograde urography through a ureteric catheter during the procedure. All patients were treated on an outpatient basis, without anesthesia. During the 1st month following extracorporeal shock wave lithotripsy, the patients received alkalization. The overall stone-free rate at 3 months was 90%. The time of radiation exposure was in the range of the opacified stones. Extracorporeal shock wave lithotripsy using Dornier HM-3 and HM-4 lithotriptors proved to be an effective procedure to treat radiolucent urinary calculi when localization of the stone is possible.

Comparison of Clinical Outcome of Extracorporeal Shockwave Lithotripsy in Patients with RadiopaquevRadiolucent Ureteral Calculi

“…6 Nowadays, this problem has been solved partially with the addition ultrasonic localization units. On the other hand, some authors [7][8][9] note that radiolucent ureteral calculi can easily be visualized indirectly by injection of contrast medium and then fragmented by SWL.…”

Shock Wave Lithotripsy Treatment of Radiolucent Ureteric Calculi with the Help of Contrast Medium

“…Alternative means have been proposed to visualise a radiolucent UC and avoid IV–CM injection, such as ‘push back’, pointer stent or retrograde ureterography [13, 14, 15]. Yet, in the light of the safety and simplicity of IV–CM application, these more invasive methods are not justified routinely, in our opinion.…”

The radiolucent ureteric calculus at the end of a contrast‐medium column: where to focus the shock waves

“…There remains a considerable perioperative risk associated with this procedure. The same is true for placing a ‘pointer’ stent next to the stone [13], or undertaking routine retrograde ureterography [14]. The easiest method for locating the stone (although not free of risk) is the administration of a drip infusion of intravenous contrast medium.…”