The effect of extracorporeal shock wave lithotripsy on the microbiological flora of urinary calculi.

Abstract

To determine whether extracorporeal shock wave lithotripsy can sterilize infection stones and, thus, decrease the recurrence rate we investigated its impact on the microbiological flora of staghorn calculi. Fragments from 17 staghorn calculi retrieved percutaneously were divided into paired sets. One set was fractured by extracorporeal shock wave lithotripsy at 18 kv. and with increasing numbers of shock waves up to 1,000. One set was fractured mechanically with a surgical clamp. Bacterial cultures were then compared between the 2 groups. Of the 17 staghorn calculi 10 showed significant bacterial growth (59%). The number of colony-forming units was not significantly different between stones fragmented by lithotripsy and those that were mechanically fractured. Furthermore, exposing fragments to an increasing number of shock waves did not alter the colony count. We conclude that extracorporeal shock wave lithotripsy has no discernible effect on the microbiological flora of infected staghorn calculi.