Long-Term Followup in 1,003 Extracorporeal Shock Wave Lithotripsy Patients

Abstract

We evaluated 1,003 patients treated with extracorporeal shock wave lithotripsy after a mean followup of 19.1 months (range 12 to 26 months). Followup excretory urograms were normal in 97 per cent of the patients. Two-thirds of the patients reported further discharge of residual fragments, mainly during the first 3 months. Rehospitalization was necessary in 57 patients. Over-all, the rate free of stones after followup was 72.2 per cent and it was not different for primary and recurrent stone patients. Rates free of stones were influenced mainly by the primary stone location and the number of stones in a renal unit. Patients with lower caliceal stones had a rate without calculi of only 57.8 per cent. Almost identical results were obtained for stones other than in the lower calix, when fragments were found in the lower calix at the time the patient was discharged from the hospital. The pre-treatment stone volume, as determined by measuring the stone area in square millimeters, did not influence the final rates free of stones for calculi up to 400 mm.2, that is 2.4 cm. of a sphere. Only calculi larger than 400 mm.2 showed an inverse relationship to the final rate free of stones. Multiple stones yielded a success rate of 64 per cent, with 90 per cent of the patients having regrowth of residual fragments. Serious complications during followup were not encountered.

Outcome of Pushback Stenting and ESWL Versus in Situ ESWL for Upper Ureteric Stone -A Comparative Study

“…Graff, et. al. showed same result that retrograde manipulation of proximal ureteral stone yields better results for ESWL 10 . In their series, success rate was 95% of pushed backed stone and 83% of in situ non-obstructing stone.…”

Treatment of Renal Stones by Extracorporeal Shockwave Lithotripsy

“…Approximately 40–50% of all treated single urinary calculi are located within the calyces, and most of these are found in the lower calyx [8, 17, 34, 46, 47, 48](table 5). This distribution has not changed during the last decades [89].…”

Fate of residual fragments after successful extracorporeal shock wave lithotripsy

“…Therefore, reassessment of a patient 3 months after ESWL has sufficient predictive value to determine the final stone-free rate and the necessity for further procedures. 6 To clarify the reason residual fragments could not be cleared, we analyzed patients with fragments 3 months after ESWL. Yu et al reported that patients with multiple stones and large stones > 21 mm in diameter had significantly lower stone-free rates compared with patients with a single stone and stones measuring < 20 mm in diameter.…”