SOLITARY KIDNEY-STONE TREATMENT BY EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY

Objectives: To determine if solitary kidney stones can be successfully treated with ESWL. Methods: 38 patients were examined, 34 stones were treated on a Dornier lithotripter HM-3, and 4 on a Siemens Lithostar. 17 stones were larger than 400 mm(2), 11 were incomplete and 6 comple te staghorn calculi. In 26 patients a catheter was placed before litho tripsy, double-J and ureteral stents in 14 and 12, respectively. Resul ts: Successful outcome of lithotripsy was achieved in 34 patients (89% ). Complete fragment elimination was recorded in 23 patients (60%), an d in 11 (29%) a negligible residuum was noticed. Treatment failure was recorded in 4 patients. In 3 patients fragment elimination was poor, and in 1 patient 3 ESWL sessions were not sufficient to commence stone destruction and we decided to operate on this patient. Anuria occurre d in 4 patients (10%). Conclusions: Our results suggest that ESWL can be successfully used in the treatment of urolithiasis in a solitary ki dney. Even in cases of staghorn stones, the obligatory placement of a double-J catheter, and strategic lithotripsy in several sessions resul t in a high success rate with a tolerable risk of complications.