Extracorporeal
shock wave
lithotripsy (ESWL) revolutionized the treatment of
urolithiasis and gradually became the favorite treatment option so that today it is considered to be the first line of treatment for more than 75% of the patients with
urolithiasis. The purpose of this study was the assessment of the therapeutic efficiency, complications and limitations of ESWL in
urolithiasis in the initial experience using a third generation electromagnetic lithotripter. Between 2007 and 2008 we performed ESWL for 167 patients with
urolithiasis. We recorded 92 patients with single stone (55.1%) and 72 with multiple
lithiasis (44.9%). Stone size varied between 7 and 24 mm with an average of 12.3±7.1 mm. Radioopac stones were found in 104 patients (62.3%) while radiolucent stones in 63 only (37.6%). Complete stone disintegration and clearance was achieved in most cases (86.2%). Complications were mostly minor and rare (transitory haematuria,
renal colic). Severe complications (renal
hematoma, steinstrasse) were diagnosed for a limited number of patients (3.6%) and their management was mostly nonsurgical or minimally invasive (retrograde ureteroscopy). ESWL is therefore the first line of treatment for
urolithiasis with stone size smaller than 2.5 cm. It has an efficiency rate above 85%, low procedure time, high safety and good tolerability (new generation lithotripters do not require
anesthesia) and minimal complications.