Literature DB >> 25305356

Lithotripter outcomes in a community practice setting: comparison of an electromagnetic and an electrohydraulic lithotripter.

Naeem Bhojani1, Jessica A Mandeville1, Tariq A Hameed1, Trevor M Soergel2, James A McAteer1, James C Williams1, Amy E Krambeck3, James E Lingeman4.   

Abstract

PURPOSE: We assessed patient outcomes using 2 widely different contemporary lithotripters.
MATERIALS AND METHODS: We performed a consecutive case series study of 355 patients in a large private practice group using a Modulith® SLX electromagnetic lithotripter in 200 patients and a LithoGold LG-380 electrohydraulic lithotripter (TRT, Woodstock, Georgia) in 155. Patients were followed at approximately 2 weeks. All preoperative and postoperative films were reviewed blindly by a dedicated genitourinary radiologist. The stone-free rate was defined as no residual fragments remaining after a single session of shock wave lithotripsy without an ancillary procedure.
RESULTS: Patients with multiple stones were excluded from analysis, leaving 76 and 142 treated with electrohydraulic and electromagnetic lithotripsy, respectively. The stone-free rate was similar for the electrohydraulic and electromagnetic lithotripters (29 of 76 patients or 38.2% and 69 of 142 or 48.6%, p = 0.15) with no difference in the stone-free outcome for renal stones (20 of 45 or 44.4% and 33 of 66 or 50%, p = 0.70) or ureteral stones (9 of 31 or 29% and 36 of 76 or 47.4%, respectively, p = 0.08). The percent of stones that did not break was similar for the electrohydraulic and electromagnetic devices (10 of 76 patients or 13.2% and 23 of 142 or 16.2%) and ureteroscopy was the most common ancillary procedure (18 of 22 or 81.8% and 30 of 40 or 75%, respectively). The overall mean number of procedures performed in patients in the 2 groups was similar (1.7 and 1.5, respectively).
CONCLUSIONS: We present lithotripsy outcomes in the setting of a suburban urology practice. Stone-free rates were modest using shock wave lithotripsy alone but access to ureteroscopy provided satisfactory outcomes overall. Although the acoustic characteristics of the electrohydraulic and electromagnetic lithotripters differ substantially, outcomes with these 2 machines were similar.
Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  equipment and supplies; kidney calculi; lithotripsy; treatment outcome; ureteral calculi

Mesh:

Year:  2014        PMID: 25305356      PMCID: PMC4412606          DOI: 10.1016/j.juro.2014.09.117

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  21 in total

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3.  Contemporary surgical management of upper urinary tract calculi.

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4.  Report of the United States cooperative study of extracorporeal shock wave lithotripsy.

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6.  First clinical experience with extracorporeally induced destruction of kidney stones by shock waves.

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8.  Improved acoustic coupling for shock wave lithotripsy.

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9.  Pretreatment with low-energy shock waves induces renal vasoconstriction during standard shock wave lithotripsy (SWL): a treatment protocol known to reduce SWL-induced renal injury.

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3.  The Era of Shock Wave Lithotripsy is Over: No.

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5.  Intracutaneous sterile water injection for pain relief during extracorporeal shock wave lithotripsy: comparison with diclofenac sodium.

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6.  The effect of hydronephrosis grade on stone-free rate in retrograde intrarenal stone surgery with flexible ureterorenoscopy.

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7.  Effects of Next-Generation Low-Energy Extracorporeal Shockwave Therapy on Erectile Dysfunction in an Animal Model of Diabetes.

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