Treatment of 1-2cm renal stones: a pilot randomised trial comparing shock wave lithotripsy, ureterorenoscopic stone removal and percutaneous nephrolithotomy.

INTERVENTION: Shock wave lithotripsy ‐ approximately 3000 shock waves focussed onto stone from an external energy source. Can be performed without any anaesthetic taking about 50 minutes. Ureterorenoscopic stone removal ‐ insertion of a fine flexible telescope into the renal tract through the urethra and destruction of stone with a laser. Requires general anaesthetic and takes about 90 minutes. Percutaneous nephrolithotomy ‐ creating a tract through the skin to the kidney through which a telescope is inserted, the stone broken up with various energy sources and the fragments removed. Requires a general anaesthetic and takes about 1 hour. Patients may undergo repeated treatment or offered one of the other alternatives until they are free of stones. CONDITION: Renal stones PRIMARY OUTCOME: Stone free rate determined using CT scan SECONDARY OUTCOME: Cost analysis ‐ by way of cost framework derived for previous studies within our unit. Includes staff, utility, building, drug, equipment and disposable costs. INCLUSION CRITERIA: Adult patients. Renal stones 10‐20mm.