Role of electrohydraulic extracorporeal shockwave lithotripsy (Dornier HM 4) in the treatment of caliceal diverticulum lithiasis

UNLABELLED: Caliceal diverticula may be congenital or acquired malformations of the collecting system, normally asymptomatic and discovered during an IVP. Indications for treatment included chronic vague flank pain, acute renal colic, urinary tract infection and hematuria. We present the results of 29 patients with symptomatic calculi in caliceal diverticula who were managed by ESWL monotherapy. All treatments were performed with electrohydraulic machine (Dornier HM 4) in ambulatory form. RESULTS: The average followup was 42 months. 12 patients (40%) had passed successfully all of the stone fragments, while 2 patients (7%) had passed more than half and 4 (13.5%) had passed less than half of the fragments. 66 per cent of patients had been rendered free of symptoms. The possibility of producing a satisfactory result (66% free of symptoms and 40% stone free by X ray) and the low morbidity of ESWL suggest that this treatment may be appropriate for majority of calculi in calicea diverticula.