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The Unique Voluminous and Staghorn Stones Treated With the Nova Ultima (Direx).80 Cases


Dr. Ruben D. Munoz Montastruc. Dr. Pierre P Tirolien. Dr. Steve Belhamou.Dr Mogues Desta. Dr Remy Grimberg.Clinique Saint Pierre.Guadeloupe.Francia
LXVII Congreso Nacional de Urologia.

Introduction
The voluminous and staghorn stones in the present time are representing a reduced percentage within the kidney stone disease. We demonstrate the obtained results in 80 stones treated with ESWL in the last years.

Material and Methods
It has been treated 69 patients for a total of 80 stones. 10 patients had bilateral unique voluminous stones and 2 patients had bilateral staghorn stones. All the cases were treated with neuroleptanalgesic. The age average was of 46 years old (20-82). Weight average: 74 kg (32-141). 26 patients had stone records and 15 suffered a stone surgery. The size of the unique stones was of 2,3 cm. The size of 7 complete staghorn stones was of more than 4 cm. And the size of 8 partial staghorn stones was of less than 4 cm.

 Stones localization Results: fragmentation 94% 
 chart01a_200  chart02a_200

Stone Free < 4mm between 4 y 10mm >10mm Failures

82% good result 12% partial fragmentation 6%l

 

The average of re-treatments was of 2.15 sessions.
The most important complication to emphasize was a sub capsular hematoma in a 20-year-old patient of 100 kg with a voluminous pelvic stone. The hematoma was discovered after-lithtoripsy through the ultrasound scan and the progress was favorable without operate needs.

 

Conclusion
Taking the obtained results, we consider that the extra corporeal lithotripsy by shockwaves is one of the choice techniques of low risk for these stones treatment. We stand out the importance of placing the double probe J in all the cases for avoid the possible kidney colic and/or an infection by urethral obstruction.
It is essential important to take some criterions of selection of the cases to obtain better results.





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