Success Rate & Complications of Extracorporeal Shock Wave Lithotripsy (ESWL) Treatment for Renal & Upper Ureteric Calculus

Background: Extracorporeal shock wave lithotripsy (ESWL) remains a widely used, non-invasive first-line option for the management of small to moderate-sized renal and upper ureteric calculi. Its success is influenced by stone size, location, density, and patient-related factors. Aim: To study the success rate and complications of ESWL treatment for renal and upper ureteric calculus. Materials and Methods: A prospective observational study was conducted on 100 adult patients with solitary renal or upper ureteric calculi measuring 7-20 mm, with Hounsfield units (HU) less than 1200, attending the urology OPD of a government medical college and super specialty hospital in Nagpur, Maharashtra, over one year (1st April 2024 to 31st March 2025), with a further three-month follow-up. Outcomes (cure/non-cure) and complications following ESWL were recorded and analyzed using SPSS with chi-square testing and multiple regression analysis. Results: Of 100 patients (71 male, 29 female), 61 had renal calculi and 39 had upper ureteric calculi. The overall stone-free/cure rate was 97%, with a marginally higher success rate for renal calculi (98.36%) compared to upper ureteric calculi (94.87%). The most common complications were loin pain (31%), hematuria (22%), and urinary tract infection (13%). Only 2% of patients required secondary intervention (URSL or DJ stenting). Conclusion: ESWL is a safe and highly effective modality for the management of renal and upper ureteric calculi of 7-20 mm with HU < 1200, achieving a high success rate with a low incidence of major complications.