The Place of ESWL in the Treatment of Urinary Stones in Patients with Renal Malformations

Introduction and Objectives. Congenital anomalies occur more often in the kidney than in any other organ. The association of abnormalities with stones has important clinical relevance. Our goal was to determine the clinical success and stone-free rates for patients with renal anomalies treated with eSWL. Materials and Methods. We performed a retrospective review of patients with renal anomalies treated at the Urology Clinic of Targu Mures, since January 2004 to December 2014. The inclusion criteria were: a clear urinary path distal of the location of the stone, a functional kidney without stasis and the stone size ≤ 25 mm ( 118 patients). We performed a total of 184 eSWL treatments (a mean of 1.559 eSWL procedures/stone). 3-month follow-up data were available for 88 patients. Results. Of the total eSWL procedures performed, 35 (29%) were horseshoe kidneys, 48 (41%) duplex kidneys, 15 (13%) malrotated kidneys, 13 (11%) ectopic kidneys and 7 (6%) hypoplastic kidneys. From the total of patients, 57 were women and 61 men. The mean age was 43.26 years. The average size of the stone was 10.228 mm. The average pacient stay was 4.77 days. Complications were subcapsular renal hematoma in two (1.69%) cases, acute pyelonephritis in two (1.69%) pacients, hematuria with vesical globe in another two (1.69%) cases and stone-street formation in 10 (8.47%). In 3 cases (2.54%) the procedure was unsuccessful and retrograde ureteroscopy was needed. Associated pathology was pressent in 61 pacients (51.69%): 21 (17.79%) presented urinary tract infection, 17 (14.41%) pacients were diagnosed with hipertension, 2 (1.69%) with diabetes and 21 (17.79%) suffered by obesity. Stone-free rate was 71.77%. Conclusions. In our oppinion eSWL is the treatment of choice for reno-ureteral lithiasis in renal malformations because is a non invasive treatment, no need for anestesia, the pacient stay is short, complications occure rarely and stone free rate is high.