[Current indications of percutaneous nephrostomy associated with extracorporeal shock wave lithotripsy in the treatment of renoureteral stones].
OBJECTIVE
To evaluate the usefulness of PN as urinary diversion in the treatment of urinary stones by ESWL.


METHODS
Between April 1996 and June 2003 9554 ESWL were performed at the lithiasis unit of the Fundación Jiménez Diaz; 0.91% required previous insertion of a PN. We performed a retrospective analysis of the 49 patients with the diagnosis of upper urinary tract stones who require treatment by ESWL associated with PN. Indications for PN were: ureteral obstruction by fragments 6%, treatment of residual stones after percutaneous nephrolithectomy 6%, ureteral obstruction by a calcified double J stent 5%, urinary sepsis 75%, and obstructive anuria in a solitary kidney 8%.


RESULTS
Overall, 87 sessions were performed in 49 patients. Number of shock waves 3996, Kv 7.69. Results where comparable in terms of stone size and composition. 57% of the patients were stone-free after one session, 24% after 2, and 19% required more than 2 sessions. There were two failures requiring surgery.


CONCLUSIONS
Although in-situ ESWL is the treatment of choice for renoureteral lithiasis, the PN is a complementary procedure when ureteral obstruction requires treatment; it is non invasive and may be successfully associated to ESWL.
García Cardoso
Juan Vicente
JV
Servicio de Urología, Fundación Jiménez Díaz, Madrid, España.
González Enguita
Carmen
C
Rodriguez Miñón Cifuentes
Jose Luis
JL
Cabrera Perez
Javier
J
Calahorra Fernández
Francisco Javier
FJ
Vela Navarrete
Remigio
R
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000628:therapy*