Extracorporeal shockwave lithotripsy of 2000 urinary calculi with the modulith SL-20: success and failure according to size and location of stones.

PURPOSE: We analyzed the successes and failures of SWL in the treatment of 2016 urinary calculi stratified according to size and position in the urinary tract.

METHODS

All the patients were treated with a Modulith SL-20 (Storz Medical).

RESULTS

The overall stone-free rate, regardless of the size and position of the stone, was 87.4%. The rate was different for kidney and ureteral stones. The stone-free rate observed for the different positions of the calculi within the kidney was upper calix 89.2%, middle calix 90.5% lower calix 84.8%, and renal pelvis 86.0%. For staghorn calculi, the stone-free rate was 60.0%. The stone-free rate for the different positions of calculi within the ureter was: upper ureter 84.3%, iliac ureter 82.4%, and pelvic ureter 91.0%. For calculi >24 mm, the retreatment rate increased, and the success rate dropped sharply.

CONCLUSION

Extracorporal shockwave lithotripsy should be the first therapeutic option for urinary calculi of <24 mm regardless of their position in the urinary tract.