Ambulatory Eswl Monotherapy in Staghorn Calculi

Objective: To evaluate the efficacy of ambulatory extracorporeal shock wave lithotripsy monotherapy in the treatment of staghorn calculi. Materials and Methods: Using piezoelectric lithotriptors (EDAP-LT01 or LT02), 268 staghorn calculi were treated. One hundred and forty three were complete and 125 were partial (65 filled the renal pelvis + one calyceal system, and 60 filled the renal pelvis + two calyceal systems). Results: Eight patients abandoned the treatment, giving 260 available cases. The overall stone free rate on ultrasound control was 53% (62% when controlled by x-ray), after an average of 6.1 sessions/stone. Cure rate was 92%, when including kidneys with clinically insignificant residual fragments (smaller than 2 mm occupying an area < 10 ). Acute pyelonephritis was a frequent complication (11.5%), most often in association with dislodgment of the ureteral stent catheter. Loss of renal function occurred in one case. Conclusion: The authors conclude that this treatment offers important advantages over open surgery or percutaneous nephrolithotomy, which should not be underestimated.