[Effect of the chemical nature of urinary calculi on the results of extracorporeal shockwave lithotripsy].
137 patients were treated by ESWL with a Sonolith 2000 lithotriptor using ultrasonography localization. 132 patients were eligible for review. Calculi were caliceal in 85 cases, pelvic in 51 cases, in the upper ureter in 1 case; 26 stones were treated by the "push and bang" technique with ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure cases were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.6%): 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria were described. Calculi with different radiographic appearances respond differently to shock wave fragmentation. Some stone compositions such as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. These calculi represented almost 30% of the series. Another treatment should be proposed to improve the results of ESWL.
Doré
B
B
Service d'Urologie, CHU, Poitiers.
Grange
P
P
Aubert
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001031:Apatites / Q000032:analysis; D002129:Calcium Oxalate / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000032:analysis* / Q000473:pathology / Q000628:therapy; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D013055:Spectrophotometry, Infrared; D013499:Surface Properties; D014463:Ultrasonography; D014527:Uric Acid / Q000032:analysis
D001031:Apatites; D002129:Calcium Oxalate; D014527:Uric Acid
Influence de la nature chimique des calculs urinaires sur les résultats de la lithotritie extra-corporelle par ondes de choc.