title: Extracorporeal shock wave lithotripsy as monotherapy for staghorn calculi--is reduced renal function a relative contraindication?
abstract: Extracorporeal shock wave lithotripsy as monotherapy for staghorn calculus is not without complications. We describe a case in which, due to markedly reduced renal function following lithotripsy for a staghorn calculus, broken fragments of calculi forming steinstrasse became cemented together to form a solid calcified tube extending from the renal pelvis to the ureteric orifice. This resulted in further loss of kidney function. The patient eventually required nephro-ureterectomy. Extreme care should be taken when using extracorporeal shock wave lithotripsy to treat staghorn calculi in kidneys with markedly diminished function to prevent further loss of function due to treatment.
authors.affiliation: Urology Unit, Mubarak Al-Kabeer Teaching Hospital, Jabriya, Kuwait.
authors.forename: K
authors.initials: K
authors.lastname: Al-Awadi
authors.forename: H
authors.initials: H
authors.lastname: Abdulhaleem
authors.forename: A
authors.initials: A
authors.lastname: Al-Tawheed
authors.forename: E 0
authors.initials: E0
authors.lastname: Kehinde
mesh_terms: D000328:Adult; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D009392:Nephrectomy; D051437:Renal Insufficiency / Q000209:etiology* / Q000601:surgery; D017211:Treatment Failure; D014515:Ureteral Diseases / Q000209:etiology / Q000601:surgery