[Correlation between chemical composition, density, and results of extracorporal lithotripsy in renal and ureteral lumbar calculi].

Based on a series of 388 patients with a total of 466 renal and lumbar ureteric stones (414 kidneys) treated between 1987 and 1990 by extracorporeal shock wave lithotripsy (ESWL) using the SONOLITH 3000* apparatus, the authors analyse the indications and results criteria for ESWL. The success criteria adopted excluded any residual fragment and considered patients lost to follow-up as failures. The success rate varied between 48.3% and 73.8% when residual fragments less than 5 mm were included and when drop-outs were excluded. A correlation was established between the radiographic appearance of the stone (dense, smooth, spiculated), its predominant spectrophometric nature and the results of ESWL: low density, spiculated Weddellite (WD) stones gave good results and very dense, smooth Whewellite (WW) stones gave less favourable results. The authors propose a refinement of the indications for ESWL in order to improve the results. Predominantly WW stones may be suitable for primary percutaneous nephrolithotomy.