Usefulness of Extracorporeal Shock Wave Lithotripsy (SWL) Monotherapy on Caliceal Diverticular Calculi

Abstract

Purpose: Caliceal diverticular calculi are difficult to treat because of limitation by the ability of stone fragments to pass through the narrow diverticular neck. Various treatment modallities have been used, including SWL, percutaneous treatment, retrograde endoscopic treatment, laparoscopy and open surgery. We evaluated SWL monotherapy as treatment approach to caliceal diverticular calculi. Materials and Methods: 10 patients were treated with an piezoelectric lithotriptor (EDAP-LT02). We evaluated stone free rate with KUB film and IVU after SWL monotherapy in caliceal diverticular calculi. Results: After a minimum followup of 1 month (mean 4.5 months), 5 patients (50 percent) had passed successfully all of the stone fragments, while 3 patients (30 percent) had passed stone fragmetnts partially. After SWL monotherapy, all symptomatic patients became free of symptoms. Conclusions: Considering the relatively noninvasiveness and possibility of producing satisfactory results (100 percent free of symptoms, 50 percent free of stones), SWL may be an acceptable form of primary management for the calculi in caliceal diverticula.