Extracorporeal lithotripsy in the management of renal stone

ABSTRACT

The introduction of extracorporeal shockwave lithotripsy [ESWL] has radically altered surgical strategy in the management of renal stone. However, as experience with the new technology is gathered, it is becoming clear that ESWL must be applied selectively and in close integration with other endourological methods if the desired result is to obtain a high stone-free rate following treatment. With stones in the renal pelvis, a 92% stone-free rate may be expected at 3 months following ESWL. With large calculi, and those in other locations in the kidney or upper ureter, the stone-free result may be as low as 30% if ESWL is used without an adjuvant percutaneous or endo-ureteral procedure. Providing that ESWL is supported by a full endourological programme, it should be possible to achieve a 90% stone-free rate, in at least 95% of patients with renal and upper ureteric stone, without recourse to surgery