Abstract
Extracorporeal shock wave lithotripsy (ESWL) was used to manage calculi in 49 renal units in 39 patients with spinal cord dysfunction. Of the kidneys, 18 had staghorn calculi, and 6 had multiple calculi greater than 1.5 cm. Twenty-four patients (62%) had undergone prior stone surgery, and 37 patients (95%) had colonized urine at the time of admission for ESWL. Preoperative placement of ureteral catheters, nephrostomy tubes, or both was carried out in 36 renal units (73%). Thirty-three renal units (67%) were rendered stone free with an average of 1.49 treatments with an average of 2340 shocks at 18 to 24 kV. Ten (56%) of the kidneys with staghorn calculi were rendered stone free. Twenty-one patients (54%) were managed successfully with one treatment. There were no serious complications, and minor complications were experienced with only 8 of 73 procedures (11%). Thus, ESWL proved to be safe and relatively effective in patients with spinal cord dysfunction, but the stone free rate was lower than that reported for percutaneous nephrostolithotomy in a similar population.
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