[Clinical study of extracorporeal shock-wave lithotripsy (ESWL) for renal and ureteral stones. The first report: end-results of 1,000 cases].

Between April, 1985 and May, 1987, we experienced 1,000 cases of extracorporeal shock-wave lithotripsy (ESWL) using a Dornier HM3. In the treatment of smaller stones, no auxiliary treatment was required. On the other hand, endourological treatments such as percutaneous nephrostomy, percutaneous nephroureterolithotomy, transurethral ureterolithotripsy or double J catheterization were combined in the treatment of larger stones. Sixteen percent of the cases were stone-free at the time of discharge from hospital but after more than 3 months 58.4% were stone-free, and including cases with insignificant residual fragments, the outcome was good in 84.2%. As major complications, cerebral bleeding due to autonomic nerve hyperreflexia was observed in one spinal cord injury patient, but generally speaking, the frequency of complications after ESWL was lower than after open surgery and the post ESWL period was rather comfortable for the patient. Surgical therapy for renal and ureteral stones will be performed mainly by ESWL. Manipulations of post-ESWL stone street or residual fragments are important, and detection of late complications is also important.