Extracorporeal shock wave lithotripsy: impact on the radiology department of a stone treatment center

Extracorporeal shock wave lithotripsy (ESWL) was performed on 925 patients (1,222 treatments) for 446 calyceal, 345 pelvic, 172 ureteral, and 108 staghorn calculi. ESWL necessitated 6.3 KUB and 1.2 renal ultrasound studies per treatment session. Intravenous urography was required in 6% of patients after ESWL. Percutaneous nephrostomy tube placement was performed by the radiologists in 10% of patients. Procedures related to nephrostomy tube placement included percutaneous nephrolithotripsy, tube changes, nephrostography, and stone fragment irrigations and retrievals. Staghorn calculi treatment with ESWL required the most procedures by radiologists (34% for partial staghorn and 56% for complete staghorn) compared with 3%, 8%, and 11% for calyceal, pelvic, and ureteral stones, respectively. In all, 8,478 radiologic examinations and procedures were performed pertaining to ESWL. This is approximately 35 studies per day. While this number may be high because it represents the early experience of the authors with ESWL, the impact on the radiology department can be substantial.