Experience Using Extracorporeal Shock-Wave Lithotripsy to Treat Urinary Calculi in Problem Kidneys

Chen, Wei‐Chuan; Lee, Ying-Huei; Huang, Jong-Khing; Chen, Ming-Tsun; Chang, Luke S.

doi:10.1159/000282507

Cited by 25 publications

(22 citation statements)

References 15 publications

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“…From our data we can confirm the observation of Chen et al [5] of a discouraging success rate in patients with MSK. Only 1 of our 16 patients was stone free at the follow-up and 2 others showed an elimination 190%.…”

Section: Discussionsupporting

confidence: 91%

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Extracorporeal Shock Wave Lithotripsy in Ureteral and Kidney Malformations

et al. 2001

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Introduction: Extracorporeal shock wave lithotripsy (SWL) has long been accepted worldwide in the treatment of kidney stone disease. Upper ureter calculi in ureteral and kidney malformations are rather frequent (10–25%). The aims of this retrospective study were to determine whether malformations might impair fragment expulsion. Material and Methods: From 1986 to 1995, 203 patients with ureteral and kidney malformations were treated and followed up for a minimum of 1 year to a maximum of 9 years. Malformations included: ureteropelvic junction stenosis, horseshoe kidney, renal malrotation, renal ectopia, duplicated ureter, nonobstructive megaureter, medullary sponge kidney and caliceal diverticula. As pretreatment workup, all patients underwent conventional studies prior to SWL treatment: X-rays, renal ultrasound, intravenous pyelography, routine blood tests and urinalysis. All examinations were repeated at regular intervals for the first 6 months. Patients with metabolic disorders were excluded from the study. We also excluded patients with a follow-up of under 1 year. We considered three groups of patients: (1) stone-free patients at plain X-rays and ultrasound; (2) >90% elimination, i.e. stone-free patients at plain X-rays and positive at ultrasound; (3) patients with residual fragments at plain X-rays and ultrasound. Results: 96 (55%) patients were in group 1 (stone free), 40 (19%) were in group 2 (>90% elimination) and 67 (26%) were in group 3 (residual). Residual stones were more frequent in patients with medullary sponge kidney (82%). In patients with renal ectopia the residual stone rate accounted for only 13% of cases. Conclusions: There is evidence that SWL should always be offered to patients with ureteral and kidney malformations. These patients should however be considered at high risk for recurrences and so they need to be carefully followed up.

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Section: Discussionsupporting

confidence: 91%

“…Chen et al [5] report 17 cases of stones in problem kidneys in adults with a stone-free rate of under 50% at a 12-month followup. In the series of Bathia and Shekar Biyani [6] of 3,000 patients, congenital malformations account for 81 cases with a 6-month stone-free rate of 90%.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Shock Wave Lithotripsy in Ureteral and Kidney Malformations

et al. 2001

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“…In a series of 8 patients reported by Bhatia et al [12] stone free rate was 100%. Chen et al [13] have reported a 50% stone free rate in patients with calculi in duplex kidneys after ESWL. 17 renal units with duplex kidneys in our series were stone free (60.7%).…”

Section: Resultsmentioning

confidence: 98%

The Role of ESWL in the Treatment of Calculi with Anomalous Kidneys

et al. 1997

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“…Despite accumulating data with larger series, there is still debate regarding the treatment of calculi in anomalous kidneys. The stone‐free rates after SWL in horseshoe kidneys, the most common anomaly of fusion, vary widely among institutions ranging from 28% up to 80% 5–7 . The reported incidence of stone formation in duplex systems is approximately 7% 4 .…”

Section: Introductionmentioning

confidence: 99%

Stones in anomalous kidneys: Results of treatment by shock wave lithotripsy in 150 patients

et al. 2004

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Objective : To determine the efficacy of shock wave lithotripsy (SWL) in anomalous kidneys. Methods : From October 1990 to October 2002, 150 patients (93 men and 57 women) with anomalous urinary tracts, including 45 horseshoe kidneys, 57 duplex kidneys, 30 malrotated kidneys, 14 pelvic and four crossed ectopic kidneys were treated with SWL for urolithiasis at the Gazi University Faculty of Medicine. Shock wave lithotripsy was performed with Siemens Lithostar plus (Siemans, Erlanger, Germany) device and all procedures were carried under fluoroscopic control.Results : The mean shock wave number and intensity received by the patients was 3770 (range, 1380-4100) shocks and 18.4 (range, 16.1-19) kV per session, respectively. The minimum success rate was obtained in patients with lower calyceal (50%) followed by middle calyceal (60%) calculi. The stonefree rate decreased and the number of sessions per patient increased with increasing stone diameter (dm). In patients with a stone dm > 30 mm, only 34% could be stone-free, compared to a rate of 92% for calculi dm < 10 mm. The overall stone free rate at the third month was 68%. The best stonefree rates were obtained in patients with ureteral duplication (80.7%). The stone-free rates in horseshoe, malrotated, pelvic and crossed ectopic kidneys were found to be 66.7%, 56.7%, 57.2% and 25%, respectively. Conclusion : Shock wave lithotripsy might be an effective and minimally invasive treatment alternative in stone-bearing anomalous kidneys. The type of anomaly, stone burden and localization seem to be the main parameters effecting the treatment success.

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Experience Using Extracorporeal Shock-Wave Lithotripsy to Treat Urinary Calculi in Problem Kidneys

Cited by 25 publications

References 15 publications

Extracorporeal Shock Wave Lithotripsy in Ureteral and Kidney Malformations

Extracorporeal Shock Wave Lithotripsy in Ureteral and Kidney Malformations

The Role of ESWL in the Treatment of Calculi with Anomalous Kidneys

Stones in anomalous kidneys: Results of treatment by shock wave lithotripsy in 150 patients

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