EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY FOR LOWER CALICEAL CALCULI

Objective: The aim of the study is to determine the effectiveness of e xtracorporeal shock wave lithotripsy (ESWL) therapy for isolated lower caliceal calculi. Patients and Methods: We analyzed 165 patients who were treated with the Siemens Lithostar Plus on an outpatient basis be tween March 1993 and August 1997. The age of patients ranged from 17 t o 70 (mean 39.11) years. The stone size varied from 4 to 42 mm, and pa tients who had stones larger than 21 mm had a double-J stent inserted prior to treatment. Results: The overall stone-free rate at 3 months w as 53.33%; whereas it was 61.79, 48.27, and 27.27% according to the st one size, less than or equal to 10, 11-20 and greater than or equal to 21 mm, respectively. Complications were rare, including 2 pyelonephri tis, 2 subcapsular hematoma formation, 24 renal colics and 8 stone str eets, which were managed by ureteral stenting or additional ESWL and r esulted in complete stone clearance. Conclusion: ESWL therapy is a rea sonable and effective method for small lower caliceal stones, but due to its relatively low stone-free and high complication rates, percutan eous nephrolithotripsy or open surgery should be considered for stones larger than 21 mm.