Minimally invasive treatment of infection staghorn stones with shock wave lithotripsy and chemolysis

We report the results in 118 patients with infection staghorn stones treate d with an anaesthesis-free minimally invasive method that combined repeated shock-wave lithotripsy (SWL) sessions (unmodified Dornier HM3 lithotripter ) and percutaneous chemolysis with Renacidin(R). The stone-free rate was 60 %. In 27 consecutive patients with infection staghorn stones representative of patients with this stone type in the population, a stone-free rate of 7 7% was recorded. The latter figure is comparable with results reported for open surgery, percutaneous surgery and sandwich therapy, and superior to th at recorded with SWL alone. During the study period, no patient referred to us with an infection staghorn stone was treated with percutaneous, uretero scopic or-open surgery, and all treatments were carried out without regiona l or general anaesthesia. The described treatment concept had a very low co mplication rate, but required a fairly long hospital stay, with a mean of 3 2 days (range: 5-82). The long period necessary for completing the treatmen t in the most complicated cases might render the procedure less attractive as a standard method, but it is nevertheless an excellent option in high-ri sk patients and in all those patients in whom other procedures are impossib le.