Extracorporeal shock-wavelithotripsy as monotherapy in coral nephrolithiasis

Abstract

278 patients with coral nephrolithiasis were examined in 1990-2003.
Extracorporeal shock-wave lithotripsy was made in 46 (16.5%)
patients with 48 coral stones (mean age 48.2+18.3 years) as a basic
treatment. The length of the concrement was 4.9+1.8 cm, width
3.8± 1.4 cm,a relative area 19.72+13.01 cm2. All the patients have initially
undergone internal drain of the kidney by a catheter (n = 13)
or stent (n = 33). Each lithotripsy session included, on the average,
28821318 impulses (17-19 kV). The number of high-energy impulses
per a session comprised 342±23. A total number of the sessions
reached 3.4±1.55. Initial destruction of the concrement requires
1.6+0.6 sessions in 10144+1081.2 impulses per one patient including
1436196.6 high-energy impulses. One procedure comprises 2-3 sessions
of lithotripsy with a 5-7 day interval. The results were assessed
at discharge after the first session and 6 months later, the degree of
stones elimination from the kidney, complications, manipulations to
manage the complications. At discharge after 3 lithotripsy sessions recovery
was achieved only in 3 out of 46 (6.52%) patients. Six months
later the fragments eliminated in 26.1% (12 of 46 patients). Mono-Hthotripsy
caused complications in 13 patients. Additional manipulations
made up 65.2%. Inefficacy of explorative treatment necessitated
conversion to open intervention in 6 (13.1%0 patients. The use
of extracorporeal lithotripsy as a monotherapy in coral nephrolithiasis
is now limited.