Between March 1986 and June 1989, 3,278 patients with upper urinary tract calculi were treated at our medical center with the Lithostar* lithotriptor. The stones were located in the calices in 41.9% of the cases, renal pelvis in 25.7% and ureter in 32.4%. Perirenal hematoma was noted in 0.5% of the patients but this resolved spontaneously within a few days. Auxillary procedures were performed in 37.3% of the cases, including Double-J stent dagger and ureteral catheter in 26.8%, ureterorenoscopy in 2.1%, percutaneous nephrostomy in 1.6%, Zeiss loop in 4.3% and percutaneous nephrolithotripsy in 3.5%. Of the treatments 83.1% were performed without general or regional anesthesia. Followup after 3 months showed a 63.8% rate free of stone. The Lithostar upgraded with the overhead lithotripsy module is called Lithostar Plus. A total of 25 patients with upper urinary stones underwent treatment with the overhead module. Initial experience revealed fragmentation of stones after the first session in 20 patients, while a second session was necessary in 5. Analgesic sedation was used in 4 patients in whom a Double-J stent was inserted.