Volume 13 Issue 11
Extracorporeal Shock Wave Lithotripsy as a Salvage Therapy after Ureteroscopy, Percutaneous Nephrolithotomy, and Pyelolithotomy in Clinically Significant Residual Stones
Submission: 28 July 2025 | Acceptance: 18 September 2025 | Publication: 6 November 2025
Dr. Muhammad Adnan¹, Prof. Murli Dhar2, Dr. Muhammad Irfaan Albreedy3, Dr. Muhammad Irdees Hanif4, Dr. Danish Niaz5
¹ Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
2 Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
3 Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
4 Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
5 Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
ABSTRACT
Objective: To determine the stone-free rate (SFR) of extracorporeal shock wave lithotripsy (ESWL) for the management of clinically significant residual stones measuring 5 to 12 mm in size.
Methodology: This cross-sectional study was conducted in the Department of Urology, SIUT Karachi, using a non-probability consecutive sampling technique. A total of 108 patients aged 18–60 years with clinically significant residual renal stones (5–12 mm) following URS, PCNL, or pyelolithotomy underwent ESWL. Data were analyzed through SPSS version 26.0 using descriptive statistics and chi-square tests, considering p < 0.05 as significant.
Results: A total of 108 patients were studied, comprising 63% males (n=68) and 37% females (n=40), with a mean age of 41.6 ± 10.5 years. The overall stone-free rate after extracorporeal shock wave lithotripsy was 87%. Stone clearance was higher in females (95%) than males (82.4%) (p = 0.051) and greater for left-sided stones (93%) compared with right-sided stones (80.4%) (p = 0.048).
Conclusion: Extracorporeal shock wave lithotripsy proved to be a highly effective and safe treatment for clinically significant residual renal stones following endourological procedures. Better outcomes were observed among female patients and those with left-sided calculi, establishing ESWL as a reliable, minimally invasive alternative for postoperative stone management and a valuable option to achieve complete stone clearance.
Keywords: Extracorporeal Shock Wave Lithotripsy (ESWL), Residual Renal Stones, Stone-Free Rate (SFR), Ureteroscopy (URS), Percutaneous Nephrolithotomy (PCNL).
