Late sequelae of ultrasonic lithotripsy of renal calculi

Abstract

We examined 82 patients 12 to 43 (mean 22) months after renal calculi had been removed by ultrasonic lithotripsy. Recurrence was noted in 2 patients but this correlated to the previous stone-forming rate. Smaller fragments that had remained in 9 patients were passed in 2, removed percutaneously in 2 and unchanged in the remainder. There was no evidence of hypertension or urinary tract infection related to the procedure. There were 62 patients available for computerized tomography and 11 per cent of the kidneys showed minute calcifications not visible on plain films. Barely visible scarring was noted on the fibrous capsule posterior to the lower pole in 22 per cent of the cases and on the abdominal wall along the former nephrostomy tract in 46 per cent. However, a cortical scar was noted in only 1 kidney and no arteriovenous fistulas were found. On dimercapto-succinic acid scans it was impossible to localize the puncture site and serial 131iodine-hippurate renograms available in 18 patients showed a 7.6 plus or minus 2.8 per cent (mean plus or minus standard error of mean) increase in function. We conclude that percutaneous nephrolithotripsy with ultrasound is a safe and effective procedure with minimal late morbidity.