ON THE SIGNIFICANCE OF CLINICALLY INSIGNI FICANT RESIDUAL FRAGMENTS AFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY

Almost 75 % of all urinary calculi can be treated by extracorporeal sh ock wave lithotripsy (ESWL). In contrast to endoscopic and open-surgic al procedures the patients are not immediately free of stones. The res idual fragments after ESWL are called clinically insignificant residua l fragments (CIRF), if the fragments are less than 5 mm in size and if there is the possibility of a spontaneous passage. But CIRF can cause ureteral obstruction. In addition, CIRF play an important role for th e risk of stone growth and stone recurrence. The metaanalysis shows th at it is not advisable to classify the CIRF only by their size. The mo rphological conditions of the urinary tract also have to be evaluated. Therefore, stone patients with CIRF after ESWL require a close follow -up and timely adjuvant therapy. All aspects mentioned lead to the con clusion to use the term ''CIRF'' with caution.