Simultaneous Treatment of Bilateral Upper Tract Calculi with Extracorporeal Shock Wave Lithotripsy

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Abstract
Seventy-six patients underwent simultaneous bilateral extracorporeal shock wave lithotripsy (ESWL) at our institution from March 1986 to June 1987. The average combined stone burden was 25 mm. Seventy-three patients (96%) had an ancillary procedure prior to ESWL. Three-month follow-up was available in 60 patients. Twenty-eight were stone free and 48 were either stone free or had insignificant fragments, for a success rate of 80%. There were 12 treatment failures, two-thirds of which were related to large stone burdens. There were no major and 10 minor complications. Six patients required subsequent procedures. Simultaneous bilateral ESWL is safe and effective for bilateral upper tract calculi. Failures can be expected when stone burden exceeds 1 cm per kidney or if one side has a stone burden 2 cm or larger.