Is long distance lithotripsy effective?

The outcome and morbidity of a group of 132 patients living near a lithotriptor was compared with that for a group of 251 patients living at a distance. The two groups were similar in age, stone burden and the need for preliminary procedures. With short follow-up, the main difference between the groups was the overall stone-free rate (20% difference, X2 = 13.5, d.f. = 1, P less than 0.001). This difference was not apparent when patients with residual fragments of 3 mm or less were included and is explained by shorter follow-up in the 'distant' group. After a minimum period of 10 days follow-up there was no significant difference in the stone-free rates. There was no significant difference between the groups in the incidence of complications (18% for the 'local' group versus 19% for the 'distant' group). The stone-free rates and incidence of complications were similarly related to stone burden in both groups. It is concluded that, within certain limitations such as inconvenience of travel, 'long distance, second generation lithotripsy' offers no disadvantage.