A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy

Abstract

This study aimed to investigate clinical effectiveness of stone disintegration by using isolation coupling pad (“icPad”) as coupling medium to reduce trapped air pockets during extracorporeal shock wave lithotripsy (ESWL). Patients underwent ESWL between Oct. 2017 and May 2018 were enrolled in this clinical observational study. An electromagnetic lithotripter (Dornier MedTech Europe GmbH Co., Germany) was used in this study. Patients were divided into icPad group P1, P2 and semi-gel group C by different coupling medium. The energy level and total number of shock wave (SW) for group P1 and C was set at level 2 and 3000 and group P2 at level 3 and 2500. The successful stone disintegration rate (SSDR) was determined to evaluate the treatment outcome. All patients were evaluated by KUB film and ultrasonography after 90 days. Complications during ESWL were recorded. A total of 300 patients satisfied the inclusion criteria. There were no significant differences in characteristics of patients and stone among three groups. The corresponding SSDRs for patients in group P1, P2 and C was 73.0%, 73.2% and 55.3%, respectively. The SSDR in group P1 was statistically higher than Group C. Comparing to semi-liquid gel, coupling medium using by icPad could achieve better treatment outcome of stone disintegration in ESWL.

Experimental Observation of Isolative Efficacy of a Solid Coupling Medium in Extracorporeal Shock Wave Lithotripsy—Implications to Nosocomial Infection Prevention

“…Air pockets would decrease the therapeutic effect of ESWL [ 16 ]. The icPad has been documented experimentally with the advantages of reducing the number of the shock wave and increasing stone disintegration rate because of reducing trapped air pockets in ESWL coupling [ 10 , 11 ]. However, the capability of icPad in preventing the cross-contamination of skin infection is unknown despite its superior coupling efficacy.…”

“…Coupling Medium : The main component of the isolation coupling pad (icPad) is polyacrylamide with a diameter of 120 mm and a thickness of 8 mm [ 11 ]. There are two sides of icPad, the A-side and B-side; the A-side is attached to the EWSL probe, and the B-side is attached to the patient body ( Figure 1 ).…”

“…The pad has efficient shock wave transmission and adhesive properties by reducing air pockets in the coupling area. icPad has documented efficacy to demonstrate better shock wave transmission, a lower number of shock waves required, and an increased rate of stone fragmentation [ 11 ].…”