Shock wave lithotripsy treatment of radiolucent ureteric calculi with the help of contrast medium

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. Copyright

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