体外衝撃波(ESWL) による腎・尿管結石破砕術の臨床経験(第IV報) - 治療開始より3年間の治療経験

We report our 3-year experience with extracorporeal shock wave lithotripsy (ESWL) since we first used it for upper urinary tract stones on September 1st, 1984. A total of 1, 225 patients (1, 320 cases) underwent 1, 647 sessions with ESWL; They consisted of 855 males (70%) and 370 females (30%). Treated stone locations were 593 renal stones, which contained 112 complete staghorn calculi, 504 ureteral stones, 110 renoureteral stones, and 1 bladder stone. ESWL monotherapy was performed on 90% of cases with renal and ureteral stones, and 46% of cases with complete staghorn calculi. In all the cases so far observed for more than 12 weeks after ESWL, 84.9% of the former showed complete discharge of the stones, and 0.7% showed no change. Only 48.9% of the later showed the complete discharge of the stones, 43.3% of which had residual stones, and 7.8% had fragments of the size of small beans. Complications, which were fever and pain, were noticed in 33.6% of the cases with renal and ureteral stones, and 64.3% of the cases with complete staghorn calculi. After ESWL, hematuria was noticed in almost cases, but the average volume of hemorrhage was 28 +/- 33 ml/day. The only contraindication of ESWL was severe obesity, and in the cases in which spontaneous stone discharge can be expected.