Extracorporeal Shock Wave Lithotripsy Monotherapy for Staghorn Stones

Kang, Sang Soo; Park, Kwang Sung; Min, Byung Kap

Abstract

During recent 3 years, we reviewed 42 patients with staghorn stones, who underwent extracorporeal shock wave lithotripsy (ESWL) with the Wolf Piezolith 2300 lithotriptor, to deter- mine whether ESWL monotherapy is a successful alternative. The results were obtained as follows: 1. Of 42 patients 10 had complete staghorn stones with 88.7mL in mean volume and 32 incomplete staghorn stones with 22.6mL in mean volume. 2.Mean session of ESWL was 7.8 in overall cases(8.8 in complete staghorn stones and 7.5 in incomplete staghorn stones). The overall success rate was 66%(60% in the complete staghorn stone and 69% in the incomplete staghorn stone). 3. Of 10 patients with stone less than 15mL, 8(80 %) showed stone -free after 5 mean sessions. Of 12 patients with stone between 15mL to 25mL, 9(76%) revealed stone-free after 6.6 mean sessions. Of 11 patients with stone between 25mL to 50mL, 6(55%) showed stone-free after 10.1 mean sessions. Of 9 patients with stone more than 50mL, 5 (56% ) revealed stone-free after 9.4 mean sessions. 4. Twelve patients showed partial response and 2 patients non-response. Of these 14 patients 6 underwent Open surgery, 5 still had remnant stones and 3 were lost to follow up. 5. The post-ESWL complications were flank pain in 18 patients(43% ), gross hematuria in 11 (26%), high fever in 4(10%) and steinstrasse in 13(31%). We conclude that ESWL monotherapy for staghorn stones is considered to be a safe and effective modality, except for bringing partial response in some cases and requiring long durations to get stone-free.