Shock Wave Lithotripsy for Medium to Large Renal Pelvic Stone Without Ureteral Stent


ABSTRACT:BACKGROUND: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.OBJECTIVE:It is to determine that patients with medium to large renal pelvic stone should be treated in situ shock wave lithotripsy without auxiliary stenting.PATIENTS & METHODS: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.RESULT: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.CONCLUSION: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.