title: [Current indications of percutaneous nephrostomy associated with extracorporeal shock wave lithotripsy in the treatment of renoureteral stones].
abstract: 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.
authors.affiliation: Servicio de Urología, Fundación Jiménez Díaz, Madrid, España.
authors.forename: Juan Vicente
authors.initials: JV
authors.lastname: García Cardoso
authors.forename: Carmen
authors.initials: C
authors.lastname: González Enguita
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Rodriguez Miñón Cifuentes
authors.forename: Javier
authors.initials: J
authors.lastname: Cabrera Perez
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Calahorra Fernández
authors.forename: Remigio
authors.initials: R
authors.lastname: Vela Navarrete
mesh_terms: 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*