Eighteen years after the first clinical
shock wave
lithotripsy (SWL), no doubt remains as to its therapeutic efficacy in ureterorenal
lithiasis. The advent of lithotriptors with a large
shock wave energy range and integration of both ultrasound and radiologic imaging equipment at the
shock wave source has meant that outpatients treatment of
urolithiasis is now feasible in a good proportion of cases. In our
lithotripsy center, from January 1995 to August 1996, 208 out of 310 patients who underwent SWL treatment for renal and ureteral stones, were outpatients. Pretreatment manoeuvres were performed in 10.6% of the patients. No major complications occurred during the treatment. Only three patients (1.4%) were admitted to hospital because of
fever, colics or perirenal haematoma in the first two days after SWL
therapy. The stone free rate was 67 and 84% respectively one and three months
after treatment. In our experience, the possibility of performing SWL treatments without
anesthesia and even analgosedation, the absence of complications and the high success rate, make outpatient treatment of
urolithiasis safe and suitable in a large number of patients.