Success of electromagnetic shock wave lithotripter asmonotherapy in large renal calculi—Our experience

Abstract

Objectives: To evaluate the success of shock wave lithotripsy (SWL) as monotherapy for solitary renalstones larger than 2 cm without ureteral stenting. Hence, if our study result demonstrates acceptable successand safety, we can recommend ESWL as a treatment option for patients with large renal calculi.

Subjects and methods: This is a prospective study conducted in the Department of Urology, Regional Insti-tute of Medical Sciences, Imphal, India, from January 2011 to December 2012. A total of 104 patientsaged between 20 and 70 years with solitary large (>2 cm) renal stones underwent ESWL using the DornierCompact Sigma Lithotripter. Stone size was calculated by measuring the largest dimension of the stonein KUB plain films. In each session, 3000–3500 shocks at frequency 60–90 min−1and intensity between1 and 4 were given. A maximum number of six sessions were given. Successful treatment was defined ascomplete clearance or residual stones smaller than 4 mm on KUB performed 3 months after the first session.

Results: Total number of patients was 104. The M:F ratio was 1:1.4. The stone size ranged from 21 to55 mm. The overall success rate was 73%. For stones >30 mm, the success rate was only 62.2% (n = 28).The number of sessions required increased as the stone size increased. The most common complicationencountered was haematuria.

Keywords: Success; Monotherapy; Large calculi