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The fate of residual fragments after extracorporeal shock wave lithotripsy monotherapy of infection stones.
J Urol. 1991 Jan; 145(1):6-9; discussion 9-10.JU

Abstract

We reviewed 53 patients with infection stones treated by extracorporeal shock wave lithotripsy (ESWL*) monotherapy to determine the long-term rate free of stones and the stone recurrence rate as correlated with the pre-treatment stone burden and the radiological presence of sand or fragments after the procedure. Long-term followup (mean 26.6 months) was available on 33 patients representing 38 kidneys. Although only 3 kidneys were free of stones immediately after ESWL, 20 were without stones at 3 months and 18 (47%) were stone-free at followup. Of 9 kidneys with fragments of more than 5 mm. after the final treatment 7 (78%) had residual fragments at 3 months and experienced stone progression. Of 9 kidneys with sand remaining 6 (66%) and all 3 kidneys that appeared to be free of stones after ESWL were without stones at followup. The 3-month plain film of the kidneys, ureters and bladder was a reliable indicator of eventual outcome. Of 20 kidneys that were free of stones at 3 months 16 remained without stones. Of 18 kidneys with residual stone particles at 3 months 14 showed disease progression, 2 had stable disease and 2 passed residual sand. Only 1 of 17 patients who were free of stones or had stable stone disease had a positive urine culture at followup. Patients with infection stone fragments 3 months after ESWL monotherapy have a high rate of stone progression (78%) and should undergo further treatment. ESWL monotherapy of infection stones requires close patient followup to assure that all residual fragments have passed and urine remains sterile.

Authors+Show Affiliations

James Buchanan Brady Foundation, Department of Surgery, New York Hospital, Cornell Medical Center, New York, New York.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1984100

Citation

Beck, E M., and R A. Riehle. "The Fate of Residual Fragments After Extracorporeal Shock Wave Lithotripsy Monotherapy of Infection Stones." The Journal of Urology, vol. 145, no. 1, 1991, pp. 6-9; discussion 9-10.
Beck EM, Riehle RA. The fate of residual fragments after extracorporeal shock wave lithotripsy monotherapy of infection stones. J Urol. 1991;145(1):6-9; discussion 9-10.
Beck, E. M., & Riehle, R. A. (1991). The fate of residual fragments after extracorporeal shock wave lithotripsy monotherapy of infection stones. The Journal of Urology, 145(1), 6-9; discussion 9-10.
Beck EM, Riehle RA. The Fate of Residual Fragments After Extracorporeal Shock Wave Lithotripsy Monotherapy of Infection Stones. J Urol. 1991;145(1):6-9; discussion 9-10. PubMed PMID: 1984100.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The fate of residual fragments after extracorporeal shock wave lithotripsy monotherapy of infection stones. AU - Beck,E M, AU - Riehle,R A,Jr PY - 1991/1/11/pubmed PY - 2001/3/28/medline PY - 1991/1/11/entrez SP - 6-9; discussion 9-10 JF - The Journal of urology JO - J Urol VL - 145 IS - 1 N2 - We reviewed 53 patients with infection stones treated by extracorporeal shock wave lithotripsy (ESWL*) monotherapy to determine the long-term rate free of stones and the stone recurrence rate as correlated with the pre-treatment stone burden and the radiological presence of sand or fragments after the procedure. Long-term followup (mean 26.6 months) was available on 33 patients representing 38 kidneys. Although only 3 kidneys were free of stones immediately after ESWL, 20 were without stones at 3 months and 18 (47%) were stone-free at followup. Of 9 kidneys with fragments of more than 5 mm. after the final treatment 7 (78%) had residual fragments at 3 months and experienced stone progression. Of 9 kidneys with sand remaining 6 (66%) and all 3 kidneys that appeared to be free of stones after ESWL were without stones at followup. The 3-month plain film of the kidneys, ureters and bladder was a reliable indicator of eventual outcome. Of 20 kidneys that were free of stones at 3 months 16 remained without stones. Of 18 kidneys with residual stone particles at 3 months 14 showed disease progression, 2 had stable disease and 2 passed residual sand. Only 1 of 17 patients who were free of stones or had stable stone disease had a positive urine culture at followup. Patients with infection stone fragments 3 months after ESWL monotherapy have a high rate of stone progression (78%) and should undergo further treatment. ESWL monotherapy of infection stones requires close patient followup to assure that all residual fragments have passed and urine remains sterile. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/1984100/The_fate_of_residual_fragments_after_extracorporeal_shock_wave_lithotripsy_monotherapy_of_infection_stones_ L2 - https://www.jurology.com/doi/10.1016/s0022-5347(17)38230-7?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -