impact of stone composition on the results of extracorporeal shock wave lithotripsy of renal calculi

This retrospective study included 341 patients with renal stones treated on the Dornier MPL9000 lithotriptor utilizing ultrasound localization. The inclusion criteria were solitary renal pelvic stones with a stone burden of 1-2 cm, normal renal functions, absent or minimal dilatation of the pelvicaliceal system and documented stone composition. The patient's demographic data, ESWL parameters, treatment results and any recorded complications were documented. Fragment sizes were measured on the early post ESWL films and by passing the expelled gravels through a metal sieve with 3 mm pore. The X-ray diffraction technique was used for stone analysis. The final success was calculated on the basis of a stone free status at 3 months from the last ESWL treatment. Whewellite and struvite calculi required higher average number of shock waves and treatment sessions, shelved higher rates of residual gravels > 3 mm in diameter and significantly lower stone free rates compared to other stone compositions. Other stones did not show statistically significant difference among each other regarding these parameters

Prospective and retrospective evaluation of blood pressure changes in patients treated by ESWL for renal stones

Forty-four patients were followed prospectively to detect the stepwise alteration in their blood pressure after ESWL. Further 181 patients, previously treated by ESWL for renal stones, were reevaluated after an average period of 20.3 months [range 6-40 months]to evaluate long term effect of ESWL on their blood pressure. Significant elevation of both systolic and diastolic pressures was found in the majority of patients, most marked, 24 hours after treatment sessions to decrease gradually over the following three months. The annual rise of systolic and diastolic pressures in treated patients was estimated to be 1.1 and 1.4 mmHg, respectively, and new onset of hypertension was calculated to be 4.07% with annual incidence of 3.9%. Changes of diastolic pressure appeared earlier and were statistically more significant than changes of the systolic pressure