Is Extracorporeal Shock Wave Lithotripsy Monotherapy a Rational Approach to Large Renal Calculi?
The advent of extracorporeal shock wave lithotripsy (ESWL†), percutaneous nephrostolithotomy (PCNL), and ureteroscopic lithotripsy has revolutionized the treatment of surgically active urolithiasis. The availability of these new technologies has led to diverse opinions as to their exact roles in treating specific urinary calculi. An example of these divergent opinions is the treatment of large renal calculi. Most authorities prefer “sandwich” therapy of large renal stones: percutaneous ultrasonic debulking, ESWL of any retained large fragments, and percutaneous removal of the resultant small particles. Other urologists, especially those in Western Europe, advocate one or more ESWL treatments as the sole therapy of large renal calculi. This paper will present the rationale for the latter approach.
KeywordsStone Formation Shock Wave Lithotripsy Calcium Oxalate Extracorporeal Shock Wave Lithotripsy Calcium Oxalate Stone
Unable to display preview. Download preview PDF.
- 1.Priestly JT and Dunn JH: Branched renal calculi. J Urol 61: 194, 1949.Google Scholar
- 12.Segura JW, Erickson SB, Wilson DM, et al: Infected renal lithiasis: results of long-term surgical and medical management. In Smith LH, Robertson WG, Finlayson B (eds): Clinical and Basic Research. New York: Plenum Publishing, 1981.Google Scholar
- 13.Jenkins AD, Segura JW, Erickson SB, et al: Infected renal lithiasis: a treatable disorder of the urinary tract. Unpublished observations, 1983.Google Scholar
- 14.Michaels EK, Fowler JE, Mariano M: Bacteriuria following extracorporeal shock wave lithotripsy of infection stones. J Urol 140: 354, 1988.Google Scholar