Treatment of staghorn calculi by extracorporeal shock wave lithotripsy monotherapy

: We evaluated retrospectively 107 patients with staghorn calculi who underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy from 1985 to 1990. The 107 patients consisted of 65 complete staghorn calculi and 55 partial staghorn calculi. Staghorn calculi required an average of 4.3 treatment sessions. Using a Dornier HM3 lithotriptor, the stone-free rate was 33% in patients with complete staghorn calculi, and 35% in patients with partial calculi. For stone evacuation following ESWL procedure, ureteral stenting, nephrostomy and transurethral lithotripsy were necessary. Four of the 21 patients who underwent ESWL monotherapy and were available for long-term followup showed stone growth, while all of the 10 patients who underwent open surgery during the previous 5 years became stone free. The average period of hospitalization and cost were 38.3 days and 700,000 yen in patients who had received open surgery, and 25.8 and 1,720,000 yen in patients receiving ESWL monotherapy. In conclusion, ESWL monotherapy is useful, and if patients require complete removal of all stone fragments, a percutaneous lithotripsy should be performed following ESWL monotherapy.