From June 1987 to October 1988, 52 staghorn calculi were treated without anesthesia by shock wave lithotripsy with the second-generation lithotriptor, Lithostar® Siemens. 36 calculi were evaluated. Multiple sessions(n = 1-6) were necessary according to the size of the stone. The mean hospital stay for complete treatment was 7 days. Double-J stenting was used in 45% of the patients with calculi of < 40 mm and in 81% of the patients with calculi of> 40 mm. After 3 months, 50% of the patients with calculi of < 40 mm were free of stones, as were 43% of the patients with calculi > 40 mm. After 9 months, the stone-free rate rose to 75%. At 3 months, the success rate (stone free or residual fragments of < 4 mm) is 87.5% and rose to 92% at 9 months. Two severe complications were observed: one patient with acute infected hydronephrosis with sepsis and one with perirenal hematoma. Shock wave lithotripsy monotherapy of staghorn calculi is possible in multiple treatment sessions. Double-J stenting is mandatory in most of the cases but, even in this condition, anesthesia is not necessary.

Keywords:
Lithotriptor, second-generation, Staghorn calculi, Shock wave monotherapy
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1990
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