CLINICAL EXPERIENCE WITH EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Report of 11 hospitals in Japan

Abstract

Between September, 1984 and June, 1986, Extracorporeal Shock Wave Lithotripter (ESWL) has been installed in 11 hospitals. During this period, totally 3, 702 patients were treated. The male to female ratio was 2.7, being higher than natural ratio of stone formers. The stone position was predominant in the renal pelvis and ureteropelvic junction (71%). Ajunctive endourologic treatments were required in 7% of the patients. The stone fragments passed completely by 6 months in 79% of the patients. The retained fragments larger than 4mm were encountered in 4%. Major complications were renal hematoma, gastrointestinal bleeding and septicemia which required careful urological management of all patients. Relatively larger stones require adjunctive endourological treatment to reduce the complication, to reserve renal function and to obtain good clinical result.
ESWL will be a first choice for stones above the iliac crista when appropriately utilized.