Use of extracorporeal shockwave lithotripsy for kidney calculi
Trapeznikova, M.F.; Dutov, V.V.
Urologiia 1: 38-43
2004
ISSN/ISBN: 1728-2985 PMID: 15022443 Document Number: 573753
278 patients with coral nephrolithiasis were examined in 1990-2003. Extracorporeal shock-wave lithotripsy was made in 46 (16.5%) patients with 48 coral stones (mean age 48.2 +/- 18.3 years) as a basic treatment. The length of the concrement was 4.9 +/- 1.8 cm, width 3.8 +/- 1.4 cm, a relative area 19.72 +/- 13.01 cm2. All the patients have initially undergone internal drain of the kidney by a catheter (n = 13) or stent (n = 33). Each lithotripsy session included, on the average, 2882 +/- 318 impulses (17-19 kV). The number of high-energy impulses per a session comprised 342 +/- 23. A total number of the sessions reached 3.4 +/- 1.55. Initial destruction of the concrement requires 1.6 +/- 0.6 sessions in 10144 +/- 1081.2 impulses per one patient including 1436 +/- 96.6 high-energy impulses. One procedure comprises 2-3 sessions of lithotripsy with a 5-7 day interval. The results were assessed at discharge after the first session and 6 months later, the degree of stones elimination from the kidney, complications, manipulations to manage the complications. At discharge after 3 lithotripsy sessions recovery was achieved only in 3 out of 46 (6.52%) patients. Six months later the fragments eliminated in 26.1% (12 of 46 patients). Monolithotripsy caused complications in 13 patients. Additional manipulations made up 65.2%. Inefficacy of explorative treatment necessitated conversion to open intervention in 6 (13.1% 0 patients. The use of extracorporeal lithotripsy as a monotherapy in coral nephrolithiasis is now limited.