Effects of repeated extracorporeal shock wave lithotripsy treatment on renal and ureteral calculi during period of stone fragments expelling

Objective To summarize the effect of repeated extracorporeal shock wave lithotripsy (ESWL) treatment on renal calculi and ureteral calculi and the incidence of complications. Methods The clinical data of 208 patients with renal calculi (128 cases) and upper ureteral calculi (80 cases) undergoing ESWL in our hospital between 2010 and 2015 were reviewed.The stone size was between 0.6 cm and 2.5 cm in diameter.Two weeks after ESWL,a kidney,ureter,and bladder (KUB) X-ray and color Doppler ultrasound were performed to evaluate the status of stone-breaking,and then ESWL procedure was repeated for the patients which stone-breaking was not enough,and the corresponding treatment measures were implemented to promote the discharge of stones according to the situation of the patients.The occurrence of complications after repeated ESWL was observed and the prevention and treatment of complications were summarized. Results A satisfied result for repeated ESWL had been achieved in the patients with failure of first lithotripsy.One hundred and four (81.2%) of 128 cases of kidney stone and 58(72.5%) of 80 cases of ureteral calculi expelled stones successfully.The infection,serious hematuria,renal colic,and formation of ureteral "stone street" were the common complications.The expelling stone a special position,use of calcium antagonists and α-1 receptor blockers,anti-infection,adjusting urine p H,double J stent placement and other interventions could reduce the occurrence of serious complications according to the situation of patients. Conclusion The repeated ESWL for patients with poor stone-breaking in the first ESWL two weeks ago can improve the chances to discharge the stone in the first stone-expelling period.The repeated ESWL following the indications strictly combined with personalized auxiliary measures can decrease the times of treatment.The effective prevention and treatment of complications with improve the security and effectiveness of ESWL,shorten the time of the stone-expelling,and minify impairments of renal function.The repeated ESWL can increase the rate of stone expelling,but not increase the incidence of complications,which is worthy of clinical popularization and application.