title: Treatment of Renal Stones ≥20 mm with Extracorporeal Shock Wave Lithotripsy.
abstract: OBJECTIVE
  To identify subgroups of patients with renal stones ≥20 mm that are more suitable for extracorporeal shock wave lithotripsy (ESWL) monotherapy.
  
  
  METHODS
  A total of 376 patients with renal stones ≥20 mm underwent monotherapy with ESWL. The treatment outcome was evaluated after 3 months of follow-up. A stone-free status or fragmentation of stones to 4 mm or smaller was considered efficacious.
  
  
  RESULTS
  At 3 months after treatment, the overall stone-free rate was 64.4%, and the efficacy rate was 70.7%. The efficacy rate was 89.4% for patients with a residual stone surface area ≤50% of baseline after the first ESWL, while the efficacy rate was 32.4% for other patients. The efficacy was 92.2% for stones ≤400 mm2 and those with lower radiodensity, as determined by a plain (KUB) film.
  
  
  CONCLUSIONS
  For renal stones with a surface area ≤400 mm2 and a radiodensity equal to or less than that of the 12th rib as determined by a KUB film, ESWL may be considered the first line of treatment, even for stones with a diameter ≥20 mm. For large stones requiring repeat treatments, the surface area of the residual stones after the first ESWL is a predictor of the final treatment result.
authors.affiliation: Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Haihu
authors.initials: H
authors.lastname: Wu
authors.forename: Jianwei
authors.initials: J
authors.lastname: Wang
authors.forename: Jiaju
authors.initials: J
authors.lastname: Lu
authors.forename: Yuqiu
authors.initials: Y
authors.lastname: Wang
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Niu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011860:Radiography, Abdominal; D012984:Software; D016896:Treatment Outcome; D014965:X-Rays; D055815:Young Adult