[Efficacy and limitations of piezoelectric extracorporeal lithotripsy in kidneys with anatomical abnormalities].

We analyze the results achieved by extracorporeal piezoelectric lithotripsy (EPL) in 40 renal units with the following anatomic anomalies: solitary kidney (10), chronic pyelonephritis (8), medulospongiosis (6), caliceal diverticula (5), intrarenal cysts (5), pyeloureteric duplicity (3), megacaliosis (1), horseshoe kidney (1), and ureterocele (1). Adequate stone fragmentation was achieved in 80% of the patients with solitary kidney; 20% developed obstructive complications (1 patient with a 15 mm.-stone and 1 patient with obstruction of double-J catheter). At 6 months, stone remnants persist in 71.4% (5/7) after stone fragmentation in those cases with pyelonephrosis. The rates for fragmentation, elimination of remaining stone fragments, and disappearance of pain are 80%, 50% and 100% for diverticular caliceal calculi, and 67%, 50% and 100% for those in kidney with medulospongiosis. We can conclude that placement of a double-J catheter is useful before EPL in patients with solitary kidney and calculi greater than 10 mm. EPL is the first therapeutic approach in symptomatic lithiasis in caliceal diverticula or precaliceal cystic dilatation (medulospongiosis).