Between March 1986 and June 1989, 3,278 patients with upper urinary tract calculi were treated at our medical center with the Lithostar lithotriptor. The stones were located in the calices in 41.9% of the cases, renal pelvis in 25.7% and ureter in 32.4%. Perirenal hematoma was noted in 0.5% of the patients but this resolved spontaneously within a few days. Auxiliary procedures were performed in 37.3% of the cases, including Double-J stent and ureteral catheter in 26.8%, ureterorenoscopy in 2.1%, percutaneous nephrostomy in 1.6%, Zeiss loop in 4.3% and percutaneous nephrolithotripsy in 3.5%. Of the treatments 83.1% were performed without general or regional anesthesia. Followup after 3 months showed a 63.8% rate free of stone. The Lithostar upgraded with the overhead lithotripsy module is called Lithostar Plus. A total of 25 patients with upper urinary stones underwent treatment with the overhead module. Initial experience revealed fragmentation of stones after the first session in 20 patients, while a second session was necessary in 5. Analgesic sedation was used in 4 patients in whom a Double-J stent was inserted.