RESUMO
Objective: To evaluate a simple procedure for dealing with radiolucent renal pelvic stones larger than 2cm using combined ureteric catheter [for stone localization] and double-J stent [for prophylaxis of stein-strasse] prior to shock wave lithotripsy [SWL]
Methods: Thirty-five patients [21 males and 4 females] with single radiolucent stone in the renal pelvis were entered in this study in the period from Feb. 2003 to March 2007. The average stone size was 25mm [range from 20 to 30 mm]. Patients underwent initial ureteric catheter insertion followed by double-J stent and referred to SWL unit. The stone localized by contrast medium injected in the catheter throughout the lithotripsy session then the catheter was removed leaving the stent. Patients were followed up 10 days post lithotripsy by ultrasonography and I.V.P or non contrast spiral C.T scanning to detect the residual stones
Results: The success rate was 91% [32 patients] 10 days after lithotripsy. Three patients [9%] showed significant residual fragments. Those patients required oral chemolysis for stone dissolution. There was no adverse reactions of contrast medium and there was no significant complications intra or post-operatively
Conclusion: Shock wave lithotripsy for radiolucent renal pelvic stones with help of contrast medium injected through a ureteric catheter is a minimally invasive technique with a high success rate. It can be considered as a simple alternative to traditional treatment modalities for radiolucent stones