Shock wave lithotripsy treatment of radiolucent ureteric calculi with the help of contrast medium

Objective: Extracorporeal shock wave lithotripsy (SWL) treatment of radiolu cent ureteric calculi (UC) is hampered by the reduced visibility of the sto ne. Intravenous contrast medium (IV-CM) administration may overcome this pr oblem by indirectly depicting the localisation of the stone. However, IV-CM administration bears known risks. The aim of this study was to compare the clinical outcome after SWL in two representative groups of patients with e ither radiolucent or radio-opaque UC. Methods: Two groups of patients, 156 with a radiolucent UC and 203 with a r adio-opaque UC, were assessed with regard to age, gender, treatment modalit ies, auxiliary measures, complications, stone properties and stone-free rat e 3 months after treatment. Results: Both groups were comparable with regard to epidemiology, treatment and clinical outcome. In both groups, stone-free rates were well within th e percentages described by other investigators. There were no adverse react ions to CM. Conclusions: The clinical outcome of SWL treatment for radiolucent ureter s tones does not differ from that for radio-opaque ureter stones. Being a non -invasive treatment, SWL with the help of IV-CM administration should be th e first-line therapy for radiolucent ureter stones. Although awareness of p ossible adverse reactions to CM is mandatory, the risk remains small. Copyr ight (C) 2001 S. Karger AG, Basel.