Staghorn Stone Treatment with Extracorporeal Shock Wave Lithotripsy: The Fate of Residual Stones

  • Gerhard J. Fuchs
  • Anna M. Fuchs
  • Peter L. Royce
  • Arnulf Stenzl
  • Christian G. Chaussy


Herein we describe the fate of 48 staghorn stones treated primarily with extracorporeal shock wave lithotripsy (ESWL) within an observation period of up to three years. Thirty patients (61%) who became stone free within eight months had two recurrences (6%) and were retreated within two years. Of 18 patients with residual stones, ten became symptomatic and needed auxiliary treatment, and nine eventually were rendered stone free. At 24 months, 84% of the original 48 patients were stone free, and the remainder were free of symptoms. Based on these observations, our approach to staghorn stones has been modified with regard to stone and patient-related parameters, such as stone burden, upper urinary tract anatomy, stone composition, and patient compliance.


Extracorporeal Shock Wave Lithotripsy Ureteral Stone Residual Stone Percutaneous Nephrolithotomy Nephrostomy Tube 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Chaussy C, Schmiedt E, Jocham D, et al: First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127: 417, 1981.Google Scholar
  2. 2.
    Fuchs G, Miller K, Rassweiler J, et al: Alternatives to open surgery for renal calculi: percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy. In Schilling W: Klinische und Experimentelle Urologie. Munchen: Zuckschwerdt, 1984.Google Scholar
  3. 3.
    Miller K, Fuchs G, Bub P, et al: Kombination von perkutaner nephrolithotomie (PCN) und extracorporaler Stoswellenlithotripsie (ESWL): eine neue Moeglichkeit zur Behandlung von Nierenausgussteinen. Akt Urol 15: 317, 1984.CrossRefGoogle Scholar
  4. 4.
    Eisenberger F, Fuchs G, Miller K, et al: Extracorporeal shock wave lithotripsy and endourology: an ideal combination for the treatment of kidney stones. World J Urol 3: 41, 1985.CrossRefGoogle Scholar
  5. 5.
    Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127, 1986.PubMedGoogle Scholar
  6. 6.
    Winfield HN, Clayman RV, Chaussy C, et al: Monotherapy of staghorn calculi: comparative study between percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy. J Urol 139: 895, 1988.PubMedGoogle Scholar
  7. 7.
    Chaussy C, Schmiedt E, Jocham D, et al: Extracorporeal Shock Wave Lithotripsy, Second Edition. Basel, Switzerland: Karger, 1986.Google Scholar
  8. 8.
    Riehle R, Fair W, Vaughn D: Extracorporeal shock wave lithotripsy for upper urinary tract calculi: one-year experience at a single center. JAMA 255: 2043, 1986.PubMedCrossRefGoogle Scholar
  9. 9.
    Chaussy C and Fuchs G: Extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper urinary stones. In Gillenwater JY, Grayhack JT, Howards SS, et al. (eds): Textbook on Adult and Pediatric Urology. Chicago: Year Book Publishers, 1987.Google Scholar
  10. 10.
    Rassweiler J, Gumpinger R, Miller K, et al: Multimodal treatment (ESWL and endourology) of complicated renal stone disease. Eur Urol 12: 294, 1986.PubMedGoogle Scholar
  11. 11.
    Scharfe T, Alken P, Muller S: Combined treatment of staghorn calculi by PNL and ESWL. J Urol 135: 298A (abstract), 1986.Google Scholar
  12. 12.
    Schulze H, Hertle L, Graff J, et al: Combined treatment of branched calculi by percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy. J Urol 135: 151A (abstract), 1986.Google Scholar
  13. 13.
    Kahnoski RJ, Lingeman JE, Coury TA, et al: Combined percutaneous and extracorporeal shock wave lithotripsy for staghorn calculi: an alternative to anatrophic nephrolithotomy. J Urol 135: 679, 1986.PubMedGoogle Scholar
  14. 14.
    Libby J and Griffith D: Large calculi and ESWL: is morbidity minimized by ureteral stents? J Urol 135: 182A (abstract), 1986.Google Scholar
  15. 15.
    Fuchs GJ, Chaussy CG, Royce PL, et al: Staghorn stones: emerging treatment strategies. Endourology 2: 1, 1987.Google Scholar
  16. 16.
    Hardy M and McLeod D: Silent renal obstruction with severe functional loss after extracorporeal shock wave lithotripsy: report on two cases. J Urol 137: 91, 1987.PubMedGoogle Scholar
  17. 17.
    Lingeman JE: Current concepts in the relative efficacy of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. World J Urol 5: 229, 1987.CrossRefGoogle Scholar
  18. 18.
    Fuchs G and Chaussy C: Extracorporeal shock wave lithotripsy for staghorn stones: reassessment of our treatment strategy. World J Urol 5: 237, 1987.CrossRefGoogle Scholar
  19. 19.
    Segura J, Patterson D, LeRoy AJ: Combined percutaneous ultrasonic lithotripsy and extracorporeal shock wave lithotripsy. World J Urol 5: 245, 1987.CrossRefGoogle Scholar
  20. 20.
    Eisenberger F, Rassweiler J, Bub P, et al: Differentiated approach to staghorn calculi using extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy: an analysis of 151 consecutive cases. World J Urol 5: 248, 1987.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Gerhard J. Fuchs
    • 1
  • Anna M. Fuchs
    • 1
  • Peter L. Royce
    • 1
  • Arnulf Stenzl
    • 1
  • Christian G. Chaussy
    • 2
  1. 1.UCLA Stone CenterUniversity of CaliforniaLos AngelesUSA
  2. 2.Department of UrologyStadt Krankenhaus HarlachingMunichWest Germany

Personalised recommendations