Solitary kidney stone treatment by extracorporeal shock wave lithotripsy.

Abstract

To determine if solitary kidney stones can be successfully treated with ESWL. 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. 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%). 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.