Strategic lithotripsy using the Doli S EMSE 220 F-XP for the management of staghorn renal calculi.
OBJECTIVE
The presentation of our results using the Dornier lithotripter (Doli) S electromagnetic shockwave emitter (EMSE) 220 F-XP for the strategic management of staghorn renal calculi.


METHODS
Sixteen patients with renal staghorn stones of more than 35 mm in maximum length on plain X-rays were treated by shock wave lithotripsy (SWL) monotherapy with the Doli S EMSE 220 F-XP. Double-J ureteral stent was inserted to all prior to the first SWL treatment. Shock wave counts varied from 2,500 to 3,600 with a shock release frequency of 70-80 pulses per minute. The number of sessions varied from 2 to 6. The interval between the SWL sessions was around 1 month. Fragmentation rate of 20-25% of the stone load per session was considered a valid criterion for progressing to further SWL sessions.


RESULTS
Nine patients became stone free at the end of SWL sessions and two patients had renal stone fragments smaller than 4 mm, which were eliminated 6 months later. Two patients developed streinstrasse that was managed with ureteroscopy. Auxiliary SWL was also performed on three patients with residual ureteral calculi. The mean follow up period was 12 months. The remaining five patients underwent open surgery for incomplete stone fragmentation. No major complications developed during the follow up period. The predominant composition of stones available for analysis was struvite.


CONCLUSIONS
Doli S EMSE 220 F-XP can be a safe and effective treatment option for renal staghorn stones on an outpatient basis.
Department of Urology, University Hospital of Heraklion, University of Crete Medical School, 71110, Heraklion, Crete, Greece.
Ioannis
I
Heretis
Charalampos
C
Mamoulakis
Vaios
V
Papadimitriou
Frank
F
Sofras
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000295:instrumentation*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014567:Urography