Minor Residual Fragments after Extracorporeal Shockwave Lithotripsy: Spontaneous Clearance or Risk Factor for Recurrent Stone Formation?
- 1 August 1997
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Endourology
- Vol. 11 (4), 227-232
- https://doi.org/10.1089/end.1997.11.227
Abstract
The aim of this study was to follow the fate of residual stone fragments (RF) <5 mm after extracorporeal shockwave lithotripsy (SWL) over a sufficiently long period to determine how many are spontaneously cleared and after what time interval. A further aim was to clarify their role in clinical outcome and stone recurrence and regrowth. The clinical and radiologic data of 266 patients were analyzed. The patients were followed up for a mean of 387 days. After SWL, 55 patients (21%) had residual fragments <5 mm in diameter. There were no significant differences between the stone-free patients and those with RF with regard to age, sex, relevant medical history, or SWL treatment. After a mean follow-up of 2.5 years, 12.7% of the residual fragments had not passed spontaneously, but all of them were clinically silent and located exclusively in the lower calices and the proximal ureter. Only 2% of the patients with RF showed stone regrowth, and no stone recurrences were observed within the follow-up period. In conclusion, although a minor pathophysiological role of RF ≤5 mm cannot be discounted in recurrence and regrowth of kidney stones after SWL, more invasive attempts to clear all minor fragments do not seem warranted.Keywords
This publication has 21 references indexed in Scilit:
- New Stone Formation: A Comparison of Extracorporeal Shock Wave Lithotripsy and Percutaneous NephrolithotomyJournal of Urology, 1996
- Clinical Implications of Clinically Insignificant Stone Fragments After Extracorporeal Shock Wave LithotripsyJournal of Urology, 1996
- Effect of Medical Management and Residual Fragments on Recurrent Stone Formation Following Shock Wave LithotripsyJournal of Urology, 1995
- Long‐term Stone Regrowth and Recurrence Rates after Extracorporeal Shock Wave LithotripsyPublished by Wiley ,1993
- Long-Term Results of Endourologic Treatment of Urinary Calculi: Investigation of Risk Factors for Recurrence or Regrowth*Journal of Endourology, 1993
- ESWL and the future of stone managementWorld Journal of Urology, 1993
- ESWL monotherapy for large-volume renal calculi: Efficacy and morbidityUrology, 1989
- EXTRACORPOREALLY INDUCED DESTRUCTION OF KIDNEY STONES BY SHOCK WAVESThe Lancet, 1980