Two-Year Follow-up of Patients Treated with Extracorporeal Shock Wave Lithotripsy

  • Daniel M. Newman
  • John W. Scott
  • James E. Lingeman


The two-year follow-up of patients treated with extracorporeal shock wave lithotripsy (ESWL) is reported with regard to factors enhancing a successful stone-free result, new stone recurrences, and the fate of residual fragments. Analysis of 1,910 patients evaluated three months following ESWL demonstrated that factors associated with an increased likelihood of a stone-free (SF) state were stone size less than 2 cm (79% SF), solitary stones (78% SF), stone location in the renal pelvis (84% SF), and the presence of normal renal anatomy (71% SF).

Renal calculi greater than 1 cm in diameter located in the lower pole of the kidney were more likely to require multiple ESWL treatments yet achieved lower stone-free rates than similar stones treated elsewhere in the renal collecting system.

New stone formation and the growth of residual fragments following ESWL were evaluated one and two years following ESWL. Overall, in patients becoming stone free following ESWL, recurrent (new) stones occurred in 8.4% of cases between three months and one year following ESWL and in another 10.6% of patients between one and two years following treatment. However, kidneys with residual fragments following ESWL were found to have fragment growth in 21.6% of cases between three months and one year following treatment (p < .001 compared to recurrent stone rate) and in 21.7% of cases between one and two years following treatment.


Shock Wave Lithotripsy Extracorporeal Shock Wave Lithotripsy Stone Size Calcium Oxalate Stone Stone Material 
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 CG, Schmiedt E, Jocham D, et al: First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127: 417, 1982.PubMedGoogle Scholar
  2. 2.
    Chaussy CH (ed): Extracorporeal Shock Wave Lithotripsy: New Aspects in the Treatment of Kidney Stone Disease. Basel, Switzerland: Karger, 1982.Google Scholar
  3. 3.
    Chaussy CG and Schmiedt E: Shock wave treatment for stones in the upper urinary tract. Urol Clin N Am 10: 743, 1983.Google Scholar
  4. 4.
    Lingeman JE, Newman DM, Mertz JHO, et al: Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. J Urol 135: 1134, 1986.PubMedGoogle Scholar
  5. 5.
    Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of ESWL. J Urol 135: 1127, 1986.PubMedGoogle Scholar
  6. 6.
    Lingeman JE, Coury TA, Newman DM, et al: Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. J Urol 138: 485, 1987.PubMedGoogle Scholar
  7. 7.
    Liedl B, Jocham D, Lunz C, et al: Five-year follow-up of urinary stone patients treated with ESWL. J Endourol 2: 157, 1988.CrossRefGoogle Scholar
  8. 8.
    Politis G and Griffith DP: ESWL: stone-free efficacy based on stone size and location. World J Urol 5: 255, 1987.CrossRefGoogle Scholar
  9. 9.
    Riehle RA, Fair WR, Vaughn ED: Extracorporeal shock wave lithotripsy for upper urinary tract calculi. JAMA 255: 2043, 1986.PubMedCrossRefGoogle Scholar
  10. 10.
    Gleeson MJ, Shabligh R, Griffith DP: Outcome of extracorporeal shock wave lithotripsy in patients with multiple renal calculi based on stone burden and location. J Endourol 2: 145, 1988.CrossRefGoogle Scholar
  11. 11.
    Amer M, Tobelem G, Economou C, et al: Renal stones: influence of radiologic data on the treatment modalities by ESWL. V World Congress on Endourology and ESWL, Cairo, November 1–4, 1987.Google Scholar
  12. 12.
    Dretler SP: Stone fragility: a new therapeutic distinction. In Lingeman JE and Newman DM (eds): Shock Wave Lithotripsy: State of the Art. New York: Plenum Press, in press.Google Scholar
  13. 13.
    Williams RE: Long-term survey of 538 patients with upper urinary tract stone. Br J Urol 35: 416, 1963.PubMedCrossRefGoogle Scholar
  14. 14.
    Williams RE: The results of conservative surgery for stone. Br J Urol 44: 292, 1972.PubMedCrossRefGoogle Scholar
  15. 15.
    Marshall V, White RH, Chaput de Saintonge M, et al: The natural history of renal and ureteral calculi. Br J Urol 47: 117, 1975.PubMedCrossRefGoogle Scholar
  16. 16.
    Ettinger B: Recurrent nephrolithiasis: natural history and effect of phosphate therapy. Am J Med 61: 200, 1976.PubMedCrossRefGoogle Scholar
  17. 17.
    Coe FL: Nephrolithiasis: Pathogenesis and Treatment. Chicago: Year Book Medical Publishers, 1978.Google Scholar
  18. 18.
    Singh M, Marshall V, Blandy J: The residual renal stone. Br J Urol 47: 125, 1975.PubMedCrossRefGoogle Scholar
  19. 19.
    Griffith DP: Infection induced stones. In Coe FL: Nephrolithiasis: Pathogenesis and Treatment. Chicago: Year Book Medical Publishers, 1978.Google Scholar
  20. 20.
    Patterson DE, Segura JW, LeRoy AJ: Long-term follow-up of patients treated by percutaneous ultrasonic lithotripsy for struvite staghorn calculi. J Endourol 1: 171, 1987.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Daniel M. Newman
    • 1
  • John W. Scott
    • 1
  • James E. Lingeman
    • 1
  1. 1.Institute for Kidney Stone DiseaseMethodist Hospital of IndianaIndianapolisUSA

Personalised recommendations