Experience of Extracorporeal Shock Wave Lithotripsy with Piezolith 2300 Device in 2077 Patients with Urinary Tract Calculi

Kang, Taek Won; Kwon, Dong Deuk; Oh, Bong Ryoul; Park, Kwangsung; Ryu, Soo Bang; Park, Yang Il

Abstract

PURPOSE
An experience of extracorporeal shock wave lithotripsy (ESWL) using the Piezolith 2300 lithotriptor in 2077 (2223 renal units) patients with urinary tract calculi is presented.
MATERIALS AND METHODS
The records of 2077 patients who underwent an ESWL between April 1990 and March 2001 were reviewed retrospectively. The ESWL treatment sessions, success rate, auxiliary procedures, and complications according to the stone size and location were analyzed.
RESULTS
Of 2223 renal units (2077 patients), 781 (35.1%) had renal, 1150 (51.7%) had ureteral and 292 (13.2%) had multiple stones. Of these cases 1116 (50.2%) had stones <1cm in size, 805 (36.2%) had stones ranging from 1 to 2cm in size, 194 (8.7%) had stones ranging from 2 to 3cm in size and 108 (4.9%) had stones ranging larger than 3cm in size, including staghorn or multiple stones. The success rate ranged from 96.3% for stones <1.0cm in diameter to 41.7% for stones >3.0cm in size, with an 86.4% overall success rate. For auxiliary measures, the push back procedure was done in 23 cases. The treatment modalities of the unsuccessful cases were open surgery in 95 cases and ureteroscopic stone removal in 31. A stone street developed in 93 patients. However, there were no other significant complications.
CONCLUSIONS
Extracorporeal shock wave lithotripsy with a piezolith 2300 lithotriptor is to be a safe and efficient outpatient procedure for the initial treatment of properly selected urinary tract calculi.