Korean J Urol.  1992 Jun;33(3):472-477.

Extracorporeal shock wave lithotripsy as monotherapy of staghorn renal calculi

Affiliations
  • 1Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.

Abstract

Between May, 1987 and July, 1991, 27 renal staghorn calculi were treated with EDAP LT-01 extracorporeal shock wave lithotriptor as monotherapy. Of the staghorn calculi 18 were complete and 9 incomplete staghorn. Of the patients 5 had urinary tract infection before treatment. Stone size in longest diameter was up to 4cm in 37.0% of the cases, 4 to 9cm in 59.2% and longer than 9cm in 3.7%, including complete or partial staghorn stones. Complete response rate was 59.3%, including complete staghorn in 44.4 % and partial staghorn in 14.8%. In the complete response cases, the number of shocks used varied from storage 60 to storage 2770 at 5/sec frequency, 100% adjust power. Complete response rate was not related with hydronephrosis, size of stones and configuration or the stones, but it was related with chemical composition of the stone. In the cases of struvite stones, they needed fewer number of shocks than any other composition for complete response. Of the stones 25.9 % were treated after double-J stents were inserted. Over aI1 25.9% of the patients needed ancillary measures, including ureteroscopic removal in 11.1%, repeated ESWL for steinstrasse in 11.9% and litholapaxy in 3.7%. Of the cases 11 developed post treatment fever and they were treated with antibiotics without clinical problems, therefore urinary tract infection is no longer contraindication of ESWL. The ESWL monotherapy is one of the recommendable treatment method for staghorn calculi.

Keyword

staghorn calculi; extracorporeal shock wave lithotripsy
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