https://journal.antispublisher.id/index.php/JMGCB <p><strong><em>Journal of Medical Genetics and Clinical Biology</em></strong> - is a peer-reviewed journal that publishes articles in English on various aspects of <strong>human </strong>and <strong>medical genetics</strong>, the <strong>genetics </strong>of experimental models and <strong>developmental anomalies</strong>.</p> PT. Antis International Publisher en-US Journal of Medical Genetics and Clinical Biology 3032-1085 https://journal.antispublisher.id/index.php/JMGCB/article/view/1943 <p><strong><em>Objective:</em></strong><em> This study aims to evaluate the clinical efficacy, success rates, and associated complication profiles of ESWL for renal calculi across specialized urology centers in Baghdad, Iraq, utilizing simulated multi-center clinical data. <strong>Method:</strong> A retrospective-simulated cohort of 300 patients (180 males, 120 females; mean age 43.2 ± 11.5 years) treated with modern electromagnetic and piezoelectric lithotripters over a 12-month period was analyzed. Stone parameters, stone-free rates (SFR) at 3 months post-procedure, session requirements, and complication indices were statistically evaluated. <strong>Results:</strong> The overall stone-free rate (SFR) at 3 months was 78.3%. For calculi smaller than 1.5 cm, the success rate reached 85.4%, compared to 57.1% for stones equal to or exceeding 1.5 cm. A secondary session was required in 21.7% of cases, predominantly driven by stone density (greater than 1000 HU) and increased stone burden. Minor complications, primarily transient gross hematuria and self-limiting renal colic, were observed in 11.7% of patients, with zero major Clavien-Dindo grade III-V complications. <strong>Novelty:</strong> ESWL demonstrates exceptional safety and efficacy in Baghdad's urological centers for small-to-moderate renal calculi. Strict patient selection based on stone size, skin-to-stone distance, and composition significantly enhances therapeutic outcomes.</em></p> Ameer Najy Obeed Ali Jaafar Obaid Ali S. Hammadi Jaafar Hamid Jaafar Al-Waeli Hanadi Tahseen Muslem Ali Kumait Hamad Copyright (c) 2026 Ameer Najy Obeed, Ali Jaafar Obaid, Ali S. Hammadi, Jaafar Hamid Jaafar Al-Waeli, Hanadi Tahseen Muslem, Ali Kumait Hamad https://creativecommons.org/licenses/by/4.0 2026-10-14 2026-10-14 3 10 1 5 10.61796/jmgcb.v3i10.1943