Outpatient extracorporeal lithotripsy of kidney stones: 1,200 treatments

Abstract

1,200 extracorporeal lithotripsies have been performed in 816 patients. 58% of the stones had a diameter of 3-10 mm, 41% measured between 11 and 20 mm and 1% were larger than 20 mm. The patients were all treated on an outpatient basis without either anesthesia or analgesia. The mean time spent at the lithotripsy center was 2 h: the mean treatment time was 46 min, i.e. 3,450 shocks at a frequency of 1.25/s. 530 patients were reviewed after 3 months. Overall, 64% of them were stone free. These results varied between 73% for stones less than 10 mm in diameter and 43% for stones larger than 20 mm in diameter. 69% of the patients presenting with a single stone were stone free at 3 months. The best results were obtained in upper caliceal stones (78%) and the least satisfactory results were obtained in the lower caliceal stones (68%). The complication rate was low: renal colic in 18% of cases, fever in 2% of cases. Altogether, 13 disobstructions were required, namely 12 endoscopic and 1 surgical. 33% of patients were retreated without admission to hospital. Outpatient extracorporeal piezoelectric lithotripsy is indicated for renal pelvic or caliceal stones less than 20 mm in diameter situated in a nonobstructed renal cavity, in a noninfected patient without any particular risk factors. 85% of patients are currently treated at the lithotripsy center on an outpatient basis.