Complex struvite calculi treated by primary extracorporeal shock wave lithotripsy and chemolysis with hemiacidrin irrigation.

Ten patients with complex struvite stones were treated successfully with primary extracorporeal shock wave lithotripsy followed by chemolysis with 10 per cent hemiacidrin renal irrigation. The average number of treatments per renal unit was 1.2 and an average of 2,688 shocks was administered per treatment. No patient required a blood transfusion. Ureteral obstruction did not occur in those patients receiving planned hemiacidrin irrigation immediately after extracorporeal shock wave lithotripsy. At 6-week followup 9 patients were free of residual fragments. The combination of extracorporeal shock wave lithotripsy and hemiacidrin chemolysis represents a satisfactory alternative to the traditional surgical management of complex struvite calculi.