INDICATIONS FOR OPEN STONE REMOVAL OF URINARY CALCULI

In a retrospective study we analyzed patients undergoing open stone re moval in the Department of Urology of the University of Tubingen, In 2 .7% of all urinary calculi, open stone surgery was necessary, Open ope ration was performed on all patients with complete staghorn calculi as well as on patients with renal pelvic stones and simultaneous morphol ogical obstruction, Partial staghorn calculi were operated on only aft er endoscopic treatment had failed. Small renal pelvic stones and uret eral stones were surgically removed only after extracorporeal shock wa ve lithotripsy (ESWL) and endoscopic surgery had been unsuccessful, Th e treatment of choice for ureteral calculi is ESWL. If ESWL is impossi ble, an endoscopic approach is advisable, Open operations of ureteral calculi only have to be performed if endoscopic therapy has failed or if there is a simultaneous morphological obstruction. Meta-analysis of publications from 1981 to 1995 confirmed our approach regarding indic ations for open stone removal, Comparison of the results reported in t he literature is very difficult because of the missing, but generally accepted definition of stone free, In addition different examination t echniques to determine the status 'stone free' make it difficult to co mpare the various studies.