Extracorporeal Shock Wave Lithotripsy Monotherapy for Large Renal Calculi by Occasional Users with a Mobile Lithotripter

Abstract

Extracorporeal shock wave lithotripsy (SWL) monotherapy with mobile Dornier HM3 and Medstone STS lithotripters was performed by occasional users to treat 156 large (> 3 cm) renal calculi. For the cases with 3 months of follow-up, stone-free rates were 50% and 41% respectively, for single(N = 26) and multiple (N = 56) stones. Pre-SWL auxiliary procedures (mainly insertion of a double-J stent) were used in 88% of the series, and the rate of post-SWL procedures for obstruction was 17%. The SWL retreatment rate was 57%. Monotherapy for large renal calculi by an occasional user of a lithotripter has the same stone-free rate as debulking percutaneous nephrostolithotomy and SWL without special post-SWL percutaneous measures. These results are unsatisfactory compared with the stone-free rate of percutaneous nephrostolithotomy and SWL for large renal calculi with special post-SWL percutaneous measures to remove residual fragments.