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

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.