Abstract
A 79-year-old bedridden female in whom bilateral small renal calculi were pointed nine months previously, presented with a high fever and non-specific abdominal symptoms. A diagnosis of bilateral renal and ureteral stones causing hydronephroureters with severe infection was made. She was referred to the urology department and treated with extracorporeal shock wave lithotripsy (ESWL). Persistent urinary tract infection caused by urease-producing bacteria, often seen in the bedridden elderly contributes to form infection-induced renal calculi. Such calculi are sometimes found in bilateral kidneys, can grow rapidly, and can often form with few, if any, symptoms. ESWL has been established as noninvasive treatment of choice for the great majority of upper urinary tract stones. All types of stones, including renal staghorn calculi, can be treated by ESWL with endourological support. Recurrence of stones after treatment is expected in approximately 40% of cases. In order to prevent recurrence, the stone should be removed totally and the patients must be observed carefully to keep the urinary tract totally free of infection.
