PCNL/ESWL v Stent/ESWL for Large Stones and Staghorn Calculi: What Have We Learned?

  • K. Miller
  • R. Bachor
  • T. Sauter
  • R. Hautmann

Abstract

In a prospective randomized study at the University of Ulm, patients with large stone burden have been treated either by extracorporeal shock wave lithotripsy (ESWL*) monotherapy under the protection of a previously placed ureteral stent (stent/ESWL) or by the combination of percutaneous. nephrostolithotomy (PCNL) and ESWL (PCNL/ESWL). For this report, 91 renal units were evaluated after a mean follow-up of 8.4 months. In both groups somewhat more than half of the patients (PCNL/ESWL 56%, stent/ESWL 54%) were found stone free at follow-up. The conclusion of this study is that mere percutaneous stone debulking is an inefficient method for improving stonefree rates, while the active percutaneous removal of stone fragments seems to be the primary factor in obtaining better results. ESWL monotherapy has proved to yield satisfactory results as long as patients have normal or only slightly dilated collecting systems.

Keywords

Shock Wave Lithotripsy Calcium Oxalate Extracorporeal Shock Wave Lithotripsy Large Stone Renal Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • K. Miller
    • 1
  • R. Bachor
    • 1
  • T. Sauter
    • 1
  • R. Hautmann
    • 1
  1. 1.Division of UrologyUniversity of UlmUlmWest Germany

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