A Prospective, Randomized Study of the Clinical Effects of Shock Wave Delivery for Unilateral Kidney Stones: 60 Versus 120 Shocks per Minute

Ng, Chi‐Fai; Lo, A.; Lee, Wai-Man; Wong, Kam-Fai; Chung, Joanne W.Y.; Gohel, Danny

doi:10.1016/j.juro.2012.05.009

Cited by 24 publications

(12 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 In a separate study they found that the 3-month SFR using the Sonolith® lithotripter depended on the SW rate, that is 35.9% at 120 SWs per minute and 50.5% at 60 SWs per minute. 10 Thus, it appears that the overall 38.2% and 48.6% SFRs that we observed at 2 weeks of followup for the LithoGold LG-380 electrohydraulic and the Modulith SLX electromagnetic devices are comparable to those of several other contemporary lithotripters.…”

Section: Discussionsupporting

confidence: 54%

See 1 more Smart Citation

Lithotripter Outcomes in a Community Practice Setting: Comparison of an Electromagnetic and an Electrohydraulic Lithotripter

et al. 2015

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 54%

“…Reports of approximately 50% or lower SFRs using SWL are not uncommon. 8–10 Multiple factors may affect this decrease in outcomes but logic points to the design changes that narrowed the focal zone and eliminated the water bath. Lithotripsy with the HM3 device was typically performed with the patient under anesthesia.…”

mentioning

confidence: 99%

Lithotripter Outcomes in a Community Practice Setting: Comparison of an Electromagnetic and an Electrohydraulic Lithotripter

et al. 2015

View full text Add to dashboard Cite

show abstract

“…1 Although SWL has since proven to deliver a very low success rate (*50%), 2,3 compared to other surgical interventions it remains the only noninvasive means to remove stones from the urinary tract. 4 As such there has been a considerable investment of effort to identify the mechanisms of shock wave (SW) action in stone breakage, with the goal of improving this valuable technology.…”

mentioning

confidence: 99%

Effect of the Body Wall on Lithotripter Shock Waves

McAteer

Williams

et al. 2014

Journal of Endourology

View full text Add to dashboard Cite

Purpose: Determine the influence of passage through the body wall on the properties of lithotripter shock waves (SWs) and the characteristics of the acoustic field of an electromagnetic lithotripter. Methods: Full-thickness ex vivo segments of pig abdominal wall were secured against the acoustic window of a test tank coupled to the lithotripter. A fiber-optic probe hydrophone was used to measure SW pressures, determine shock rise time, and map the acoustic field in the focal plane. Results: Peak positive pressure on axis was attenuated roughly proportional to tissue thickness-approximately 6% per cm. Irregularities in the tissue path affected the symmetry of SW focusing, shifting the maximum peak positive pressure laterally by as much as *2 mm. Within the time resolution of the hydrophone (7-15 ns), shock rise time was unchanged, measuring *17-21 ns with and without tissue present. Mapping of the field showed no effect of the body wall on focal width, regardless of thickness of the body wall. Conclusions: Passage through the body wall has minimal effect on the characteristics of lithotripter SWs. Other than reducing pulse amplitude and having the potential to affect the symmetry of the focused wave, the body wall has little influence on the acoustic field. These findings help to validate laboratory assessment of lithotripter acoustic field and suggest that the properties of SWs in the body are much the same as have been measured in vitro.

show abstract

“…To hasten improvements in SWL safety, there is a need to develop rapid and noninvasive methods for quantifying the tissue injury response to SWL treatment strategies. One approach is the use of plasma and urinary biomarkers of tissue injury, which have been assessed in renal SWL research and yielded mixed results [13,14]. Little is known on whether such biomarkers are correlated to any direct measurement of lithotripsy-induced renal damage [15].…”

Section: Introductionmentioning

confidence: 99%

Development of a novel magnetic resonance imaging acquisition and analysis workflow for the quantification of shock wave lithotripsy-induced renal hemorrhagic injury

et al. 2017

View full text Add to dashboard Cite

Introduction The current accepted standard for quantifying shock wave lithotripsy (SWL)-induced tissue damage is based on morphometric detection of renal hemorrhage in serial tissue sections from fixed kidneys. This methodology is time and labor intensive and is tissue destructive. We have developed a non-destructive magnetic resonance imaging (MRI) method that permits rapid assessment of SWL-induced hemorrhagic lesion volumes in post-mortem kidneys using native tissue contrast to reduce cycle time. Methods Kidneys of anesthetized pigs were targeted with shock waves using the Dornier Compact S lithotripter. Harvested kidneys were then prepared for tissue injury quantification. T1 weighted (T1W) and T2 weighted (T2W) images were acquired on a Siemens 3T Tim Trio MRI scanner. Images were co-registered, normalized, difference (T1W–T2W) images generated, and volumes classified and segmented using a Multi-Spectral Neural Network (MSNN) classifier. Kidneys were then subjected to standard morphometric analysis for measurement of lesion volumes. Results Classifications of T1W, T2W and difference image volumes were correlated with morphometric measurements of whole kidney and parenchymal lesion volumes. From these relationships, a mathematical model was developed that allowed predictions of the morphological parenchymal lesion volume from MRI whole kidney lesion volumes. Predictions and morphology were highly correlated (R=0.9691, n=20) and described by the relationship y=0.84x+0.09, and highly accurate with a sum of squares difference error of 0.79%. Conclusions MRI and the MSNN classifier provide a semi-automated segmentation approach, which provide a rapid and reliable means to quantify renal injury lesion volumes due to SWL.

show abstract

A Prospective, Randomized Study of the Clinical Effects of Shock Wave Delivery for Unilateral Kidney Stones: 60 Versus 120 Shocks per Minute

Cited by 24 publications

References 20 publications

Lithotripter Outcomes in a Community Practice Setting: Comparison of an Electromagnetic and an Electrohydraulic Lithotripter

Lithotripter Outcomes in a Community Practice Setting: Comparison of an Electromagnetic and an Electrohydraulic Lithotripter

Effect of the Body Wall on Lithotripter Shock Waves

Development of a novel magnetic resonance imaging acquisition and analysis workflow for the quantification of shock wave lithotripsy-induced renal hemorrhagic injury

Contact Info

Product

Resources

About