Shock wave lithotripsy for medium to large renal pelvic stone without ureteral stent

ABSTRACT

Although Double J ureteral stent placement has been widely used to prevent steinstrasse after fragmentation of larger stones. But, particularly more recently, its preventive efficacy has been questioned. It is to determine that patients with medium to large renal pelvic stone should be treated in situ shock wave lithotripsy without auxiliary stenting. Between October 2007 and December 2008 a series of 55 patients with unilateral renal pelvic stone with at least one diameter between 15 and 30mm. were treated with extracorporeal shock wave lithotripsy in situ without auxiliary stenting. Fifty five patients the mean age 40 years, 21 being males and 34 were females. With renal pelvic stone, clearance of stone fragments was analyzed by x-ray KUB and ultrasound on first month and three months after treatment or until stone fragments were cleared. Twenty three 42% were stone free three months after treatment while 32 patients 58% were having residual fragments. Treatment complications consisted of steinstrasse in seven 12.7%, pyelonephritis in two, four of steinstrasse cleared spontaneously, the other three steinstrasse were treated successfully with ESWL. Shock wave lithotripsy in situ for medium to large renal pelvic calculi [15 to 30 mm] is reasonable procedure, avoiding the morbidity of ureteral stent and additional cost