Extracorporeal shock wave lithotripsy with a transportable electrohydraulic lithotripter: Experience with >300 patients

David M. Albala, Khurram M. Siddiqui, Brant Fulmer, Joseph Alioto, Jeffery Frankel, Manoj Monga

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: To review a multicentre experience of using a transportable lithotripter (STS-T, Medstone, Inc, Aliso Viejo, CA. USA) for treating patients with urolithiasis in all parts of the urinary tract. PATIENTS AND METHODS: In all, 326 patients with a total of 370 stones were treated as outpatients with the STS-T lithotripter. All patients received a single shock wave lithotripsy treatment and were followed after 4-6 weeks in the outpatient clinic, the primary endpoint being to determine the efficacy (as defined by the stone-free rate). Secondary objectives included establishing a database of patient demographic information, stone characteristics, stone location, procedural endpoints, and complication rates. RESULTS: In all there were 370 procedures, with a mean of 2394 shocks administered at an energy level of 24 kV. The mean treatment time was 51 min, excluding anaesthesia-induction time. The mean stone aggregate size was 8.2 mm; 62% of the stones were in the kidney while 38% were in various locations in the ureter. Of the treated stones, 90% had definite or probable evidence of fragmentation. The overall stone-free rate after one treatment with the STS-T was 52.8%. Of patients with residual fragments, most (61%) had fragments of <4 mm in aggregate diameter. The overall complication rate was 3.8%, the most common complication being postoperative pain. CONCLUSION: The Medstone STS-T lithotripter was an effective device for treating urolithiasis in all parts of the urinary tract. This system had a high margin of safety, as shown by the low complication rate. With no apparent sacrifice of efficacy compared to first-generation or fixed (not transportable) second-generation devices, the Medstone STS-T represents an important advance in the development of a truly transportable lithotripter.

Original languageEnglish
Pages (from-to)603-607
Number of pages5
JournalBJU International
Volume96
Issue number4
DOIs
Publication statusPublished - Sep 2005

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Keywords

  • ESWL
  • Lithotripter
  • Outcome
  • Spark gap lithotripsy
  • Stones
  • Urolithiasis

ASJC Scopus subject areas

  • Urology

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