Long-Term Results of Extracorporeal Shock Wave Lithotripsy in Renal Stone Treatment

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Abstract
Extracorporeal shock wave lithotripsy (SWL) treatment for renal stones has been proved safe and effective in the last 10 years. However, we needed to observe the patients for a longer period than a 3-month control to settle the fate of residual fragments. Two hundred fifty-four patients treated with SWL for different types of stones in solitary kidneys have been examined between 24 and 56 months (mean 42 months) after the treatment. When discharged, 31.5% (80) of the patients were stone free, whereas 65.3% (166) had stone dust or passable fragments. After 3 months, 162 (64.8%) of 250 were stone free, and 84 (33.6%) had dust or passable fragments. Twenty-nine (74.4%) of the infected patients had residual fragments, which regrew after discharge in 19 patients (65%). There were 136 stone-free patients (55%) after a followup longer than 24 months (mean 42 months). Recurrence of stones was observed in 34 patients (13.8%), and regrowth of fragments was observed in 55 patients (22.3%). Of 85 evaluable patients with dust and fragments at 3-month followup, 55 (64.7%) had fragment regrowth, 22 (25.8%) were unchanged, and 8 patients (9.4%) were stone free at long-term followup. The fragments still present after 3 months are unlikely to be cleared in a longer followup. The observed incidence of new-onset hypertension in this series was 6.1% (15 patients). In conclusion, SWL should be considered the safe first-choice treatment for all renal stones, in some cases together with auxilliary tools such percutaneous methods.