Residual fragments after ESWL which are clinically significant are a clear indication to their removal. The flexible endoscopic extraction represents the method of choice for its minimal invasion. We report a case of residual fragments after ESWL with recurrent colics and hydronephrosis treated with a double J stenting. Ten fragments were removed retrograde with a flexible ureteroscope and a nitinol basket. We used a ureteral sheath to facilitate the many reintroduction of the instrument.
We believe this technique is to be considered as the first choice treatment for this kind of pathology.
StreemS., YostA., MaschaE.Clinical Implications of Clinically Insignificant Stone Fragments After Extracorporeal Shock Wave Lithotripsy. J Urol1996; 155: 1186–90.
2.
ParrN.J., RitchieA.W., SmithG., MoussaS.A., TolleyD.A.Does further extracorporeal lithotripsy promote clearance of small residual fragments? Brit. J Urol1991, 68: 565.
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MoonY.T., KimS.C.Fate of clinically insignificant residual fragments after extracorporeal shock wave lithotripsy with EDAP LT-01 lithotripter. J Endourol1993; 7: 453.
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ElbahnasyA.M., ShalhavA.L., HoenigD.M.Lower caliceal stone clearance after shock wave lithotripsy or ureteroscopy: the impact of lower pole radiographic anatomy. J Urol1998; 159: 676–82.
