Percutaneous Nephrolithotomy and ESWL versus Ureteral Stent and ESWL for the Treatment of Large Renal Calculi and Staghorn Calculi: Preliminary Results of a Prospective, Randomized Study
Recently published data indicate that morbidity after ESWL of large renal calculi (> 2 cm) can be significantly diminished by inserting a ureteral double-J stent prior to treatment. A prospective, randomized study was designed to clarify if ESWL plus ureteral stenting is preferable to the combination of PNL/ESWL for the treatment of large renal calculi (> 2.5 cm) and staghorn stones. To date 74 patients have entered the study; preliminary data of 53 patients are available.
Number of patients
Age (mean, years)
Hospital Stay (days)
Stone Free (at discharge)
Stone Free (follow-up)
Complications (bleeding, septicemia, deterioration of renal function) are significantly more frequent following PNL/ESWL, whereas the need for auxiliary measures (mainly percutaneous nephrostomies) is greater following stent/ESWL. Results after an average follow-up of three months indicate that only 15% of patients treated with ESWL and ureteral stenting were free of stones, suggesting that longer follow-up is necessary for the assessment of the definitive value of this treatment modality in the treatment of large renal calculi. With the availability of anesthesia-free ESWL in the Dornier HM3, this topic is currently of particular interest.
- Abomelha MS, Said MT, Otaibi KE, et al: ESWL monotherapy in staghorn calculi. V World Congress on Endourology and ESWL. Cairo, 1987.
- Alken P, Scharfe T, Rorig J, et al: Staghorn stones: surgery or ESWL and PNL? V World Congress on Endourology and ESWL. Cairo, 1987.
- Chaussy, CG, Schmiedt, E, Jocham, D (1982) First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127: pp. 417
- Drach, GW, Dretler, SP, Fair, WR (1986) Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: pp. 1127
- Eisenberger, F, Rassweiler, J, Bub, P (1987) Differentiated approach to staghorn calculi using extracorporeal shock wave lithotripsy and percutaneous nephrolithotripsy: an analysis of 151 consecutive cases. World J Urol 5: pp. 248 CrossRef
- Fuchs, G, Miller, K, Rassweiler, J (1985) One-year experience with Dornier lithotripter. Eur Urol 11: pp. 145
- Graff, J, Pastor, J, Herberhold, D (1987) Technical modifications of the Dornier HM3 lithotripter with an improved anesthesia technique. World J Urol 5: pp. 202 CrossRef
- Groenveld AE: ESWL monotherapy in large stone burdens. V World Congress on Endourology and ESWL. Cairo, 1987.
- Libby, J, Meacham, RB, Griffith, DG (1988) Role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. J Urol 139: pp. 15
- Lingeman, JE (1987) Current concepts on the relative efficacy of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. World J Urol 5: pp. 229 CrossRef
- Miller K, Bachor R, Hautmann R: Percutaneous nephrolithotomy/ESWL versus ureteral stent/ESWL for the treatment of large renal calculi and staghorn stones: a prospective randomized study. V World Congress on Endourology and ESWL. Cairo, 1987.
- Patterson, DE, Segura, JW, LeRoy, AJ (1987) Long-term follow-up of patients treated by percutaneous ultrasonic lithotripsy for struvite staghorn calculi. J Endourol 1: pp. 177 CrossRef
- Snyder, JA, Rosenblum, JL, Smith, AD (1987) Endourological removal of staghorn calculi in the elderly: analysis of 42 cases. J Endourol 1: pp. 123 CrossRef
- Tiselius, HG, Hellgren, E, Wall, I (1988) Infectious staghorn stones treated with ESWL and hemiacidrin irrigation. J Endourol 2: pp. 137 CrossRef
- Zwergel, U, Neisius, D, Zwergel, T (1987) Results and clinical management of extracorporeal piezoelectric lithotripsy (EPL) in 1,321 consecutive treatments. World J Urol 5: pp. 213 CrossRef
- Percutaneous Nephrolithotomy and ESWL versus Ureteral Stent and ESWL for the Treatment of Large Renal Calculi and Staghorn Calculi: Preliminary Results of a Prospective, Randomized Study
- Book Title
- Shock Wave Lithotripsy
- Book Subtitle
- State of the Art
- Book Part
- Part II
- pp 89-93
- Print ISBN
- Online ISBN
- Springer US
- Copyright Holder
- Springer-Verlag US
- Additional Links
- Industry Sectors
- eBook Packages
- Editor Affiliations
- 1. Institute for Kidney Stone Disease, Methodist Hospital of Indiana
- Author Affiliations
- 2. Division of Urology, University of Ulm, Prittwitz Street 43, 7900, Ulm, West Germany
To view the rest of this content please follow the download PDF link above.