title: Extracorporeal shock-wave lithotripsy for small symptomatic renal calculi: is it effective?
abstract: Renal calculi with a diameter of less than 5 mm can pass spontaneously. However, some patients have small symptomatic renal calculi for more than 3 months. We evaluated the results of extracorporeal shock-wave lithotripsy in 38 patients with such stones. Patients presented with loin pain, hematuria, infection, or a combination of complaints. Average stone size was 18 mm2. After a wait of 3 months for spontaneous evacuation without success, all patients were treated with a Siemens Lithostar. Three months after treatment, 19 patients (50%) were completely free of stones, but 7 still had complaints; of the 19 patients with residual fragments, 8 (42%) were free of complaints. Both evacuation and resolution of complaints were achieved in only 12 of the 38 patients (32%). We conclude that one should be reluctant to treat small renal calculi, because spontaneous evacuation occurs in about 80% and the results of treatment are restricted.
authors.affiliation: Department of Urology, Radboud University Hospital Nijmegen, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hendrikx
authors.forename: A F
authors.initials: AF
authors.lastname: Bierkens
authors.forename: F M
authors.initials: FM
authors.lastname: Debruyne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005334:Fever / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011856:Radiographic Image Enhancement
chemical_list: D003287:Contrast Media