Extracorporeal Shock Wave Lithotripsy of Contrast-Negative Renal and Ureteral Stones

Abstract

During a 32-month period, extracorporeal shock wave lithotripsy (ESWL) was used to treat 207 non-opaque calculi (187 radiolucent, 20 slightly radiopaque). Adequate radiological visualization was obtained with retrograde pyelography in 199 cases while intravenous pyelography was used when a ureteral stent could not be passed in eight cases. Three cases presented complications (two episodes of sepsis and one perirenal hematoma), and one patient had a rapid recurrence of a cystine stone. Intravenous alkalinization was begun during hospitalization and continued orally after discharge. Post-treatment particles present a greater surface area to alkaline urine than the original stone, accelerating the process of chemical dissolution. Of 182 patients with adequate follow-up, 154 (84.6%) became completely stone free.