In recent years, newer modalities for imaging the urinary tract have been introduced, such as contrast computed tomography (CT urogram), non-contrast enhanced helical CT (UHCT), magnetic resonance urography and real-time ultrasonography (US), particularly power Doppler US. Intravenous urograms are beneficial for displaying calyceal anatomy and its relationship to stone burden. Since the introduction of extracorporeal shock wave lithotripsy (ESWL) in the early 1980s, intravenous (excretory) urograms (IVU) have been used to plan treatment for patients with renal and ureteric stones. Patients imaged by UHCT or US + X-ray KUB prior to ESWL for uncomplicated renal and ureteric stones do not require IVU. The complication rate and need for ancillary procedures was comparable across the three groups. The stone-free rate was 98% for the IVU and UHCT groups, and 97% for the US + X-ray KUB group. There was no statistically significantly difference for number of ESWL sessions, number of shock waves and use of ancillary procedures between the three groups. The groups were matched in terms of age and gender, as well as location, side and size of stones. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU ii) non-contrast enhanced helical computed tomography (UHCT) and iii) ultrasound (US) + X-ray kidney, ureter and bladder (KUB). This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique. An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL).
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