Infectious Staghorn Stones Treated with Extracorporeal Shock Wave Lithotripsy and Hemiacidrin
Thirty patients with staghorn stones were treated with a combination of extracorporeal shock wave lithotripsy (ESWL) followed by hemiacidrin irrigation. Following the insertion of one or two small percutaneous nephrostomy catheters and a double-J stent, disintegration of the stone was performed with a Dornier HM lithotripter equipped with a 15.6 cm ellipsoid and standard generator (80 nanofarad) system. Immediately after ESWL, irrigation with 10% solution of hemiacidrin was initiated. Treatment was continued until the patients were either stone free or only had small residual fragments no longer affected by hemiacidrin.
This treatment protocol rendered 52% of kidneys stone free at four-week follow-up, and another 24% had only small (< 4 mm) residual fragments.
The combination of ESWL and hemiacidrin irrigation provides an alternative for patients otherwise requiring percutaneous debulking prior to ESWL. Currently all patients are treated without general or regional anesthesia.
KeywordsExtracorporeal Shock Wave Lithotripsy Energy Index Residual Fragment Staghorn Stone Nephrostomy Catheter
Unable to display preview. Download preview PDF.
- 2.Gil-Vernet JM: Pyelolithotomy. In Roth RA and Finlayson B (eds): Stones-Clinical Management of Urolithiasis, Vol 6. International perspectives in urology. The Williams & Wilkins Company, 1983.Google Scholar
- 3.Russel JM, Harrison LH, Boyce WH: Recurrent urolithiasis following anatrophic nephrolithotomy. J Urol 125: 471, 1981.Google Scholar
- 12.Wall I, Tiselius HG, Larsson L: Hemiacidrin-a useful complement in the treatment of infectious renal stones. (manuscript in preparation.)Google Scholar
- 15.Resnick MI: Evaluation and management of infection stones. Urol Clin N Am 8: 265, 1981.Google Scholar