Extracorporeal shockwave lithotripsy (ESWL) and endourology: an ideal combination for the treatment of kidney stones

Summary Operative management of renal calculi has changed radically in the past decade. New imaging techniques for intraoperative stone localization, the use of cooling techniques and drugs to protect renal function, and new operative techniques have even made possible the removal of complete staghorn calculi in short and kidney-preserving procedures. Considerable morbidity, however, still results from conventional renal stone surgery, especially when repeated operations are necessary for recurrent stone disease. Since the introduction of new less invasive methods, such as percutaneous nephrolithotomy (PCN) and stone extraction using an especially designed ureteroscope (URS), and above all, since the clinical application of extracorporeal shock wave lithotripsy (ESWL), policies for stone management have changed completely. A review of 1340 consecutive patients presenting with stones between October 1983 and October 1984 shows that only 7% of all patients with urinary stones — 1% of all renal stones and 15% of all ureteral stones — still required an open operation.Present address: Department of Urology, UCLA School of Medicine, 10833 Le Conte Ave. Los Angeles, CA 90024, USA