Objective: To assess the short-term efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) with the standard Dornier Lithotripter S 220 F EMSE in the treatment of a large population of 736 patients with renal and ureteral stones. This is the only report with more than 1000 treatments performed with this device.

Methods: Between January 2003 and July 2006, a total of 479 renal and 257 ureteral stones were treated with 1168 ESWL sessions. ESWL was performed on an outpatient basis. Patients were evaluated after 1 and 3 months. Stone size and location, total number of shockwaves, stone-free rate, and complications were investigated.

Results: The stone-free rate for renal calculi was 60.5% at 1 month and 82.5% at 3 months. The stone-free rate for ureteral stones was 58% at 1 month and 82.9% at 3 months. The overall stone-free rate was 59.6% at 1 month and 82.5% at 3 months. Anesthesia was not needed in any case. Analgesia with hospital admission was necessary in 15 patients (2.0%). The major complications observed were renal hematoma in only 1 patient (0.1%), obstruction with sepsis in 3 patients (0.4%), and steinstrasse development in 5 patients (0.7%).

Conclusions: The Dornier Lithotripter S 220 F EMSE is a safe and effective tool in the treatment of urolithiasis; the lack of invasiveness and absence of anesthesia confirm its worthy role as an alternative to ureterorenoscopy and percutaneous nephrolitotomy.

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http://dx.doi.org/10.1016/j.urology.2009.05.101DOI Listing

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