Extracorporeal shock wave lithotripsy experience with wolf piezolith 2300 device in 500 patients with upper urinary tract calculi

Yang, Ho Seung; Park, Kwang Sung; Min, Byung Kap

Abstract

An experience of extracorporeal shock wave lithotripsy (ESWL) using the Wolf Piezolith 2300 lithotriptor in 500 patients with upper urinary tract calculi is presented. Between April 1990 and April 1992, 500 patients (526 renal units) 8 to 78 years old were treated and followed up for at least 3 months. Of 526 renal units, 199 (37.8 per cent) had renal, 275 (52.3 per cent) ureteral and 52 (9.9 per cent) multiple stones. Of these cases 50.4 per cent had stones smaller than 1cm, 33.7 per cent from 1 to 2cm, 8.5 per cent from 2 to 3cm and 7.4 per cent larger than 3cm, including staghorn or multiple stones. The success rate ranged from 100 per cent for stones smaller than 1.0cm in diameter to 71.8 per cent for stones larger than 3.0cm, with a 94.5 per cent of overall success rate. For auxiliary measures, push back procedure was done in 19 patients, Double J stents placed in 3 and nephrostomy performed in 6 patients. There were no significant complications. Stone street developed in 74 patients. Of these, stone fragments passed spontaneously in 37 and treated successfully with repeat ESWL in 24 and with manipulation by ureteral catheter in 12. Only 1 patient required percutaneous nephrostomy because of ureteral obstruction by stone fragments. Therefore. extracorporeal shock wave lithotripsy with piezoelectric lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of upper urinary tract calculi.