Extracorporeal Shock Wave Lithotripsy of Staghorn and Large Calculi

Abstract

Sixty-one patients with staghorn calculi (complete, 19 cases; partial, 28 cases) and 14 patients with large upper urinary tract stone (over 3 cm in diameter) were treated by extracorporeal shock wave lithotripsy (ESWL) between April 1, 1986, and October 30, 1987. Fracturization occurred in 98.4% of cases. There was only one patient whose staghorn calculi (composed of cystine) could not be fracturized. Twenty-seven cases (57.4%) required preoperative auxiliary procedures in staghorn calculi cases, and five cases (35.7%) of large stones required similar measures. Postoperative auxiliary measures were necessary in 15 cases (24.2%). As stone fragments passed through the ureter, symptoms such as fever and pain occurred in 52 cases (85.2%).

In all cases, 72.7% of patients with double-J stents, 60% of patients with percutaneous nephrostomy, and 65.5% of patients without preoperative auxiliary procedures became stone free.