Shock Wave Lithotripsy Treatment of Radiolucent Ureteric Calculi with the Help of Contrast Medium

Abstract

Objective: Extracorporeal shock wave lithotripsy (SWL) treatment of radiolucent ureteric calculi (UC) is hampered by the reduced visibility of the stone. Intravenous contrast medium (IV–CM) administration may overcome this problem by indirectly depicting the localisation of the stone. However, IV–CM administration bears known risks. The aim of this study was to compare the clinical outcome after SWL in two representative groups of patients with either radiolucent or radio–opaque UC. Methods: Two groups of patients, 156 with a radiolucent UC and 203 with a radio–opaque UC, were assessed with regard to age, gender, treatment modalities, auxiliary measures, complications, stone properties and stone–free rate 3 months after treatment. Results: Both groups were comparable with regard to epidemiology, treatment and clinical outcome. In both groups, stone–free rates were well within the percentages described by other investigators. There were no adverse reactions to CM. Conclusions: The clinical outcome of SWL treatment for radiolucent ureter stones does not differ from that for radio–opaque ureter stones. Being a non–invasive treatment, SWL with the help of IV–CM administration should be the first–line therapy for radiolucent ureter stones. Although awareness of possible adverse reactions to CM is mandatory, the risk remains small.