Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

Zengın, Kürşad; Şener, Nevzat Can; Baş, Okan; Nalbant, İsmail; Alisir, Inan

doi:10.1590/s1677-5538.ibju.2014.05.10

Cited by 11 publications

(5 citation statements)

References 12 publications

(14 reference statements)

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“…This has been shown in the study by Zengin et al. [ 9 ]. They evaluated patients who underwent PCNL using three different types of lithotripsy devices—pneumatic, ultrasonic and combination.…”

Section: Discussionsupporting

confidence: 74%

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The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

Singh

Sundaram

Jai

et al. 2022

Asian Journal of Urology

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Section: Discussionsupporting

confidence: 74%

“…They evaluated patients who underwent PCNL using three different types of lithotripsy devices—pneumatic, ultrasonic and combination. The stone free rate was 67.7% in the pneumatic group whereas in the combination group using both pneumatic and ultrasonic with suction, the stone free rate was much higher at 85.5% ( p =0.04) [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

Singh

Sundaram

Jai

et al. 2022

Asian Journal of Urology

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“…In a study by Kursad Zengin et al, in 2014, over 514 patients, a significant difference was found between pneumatic lithotripter and Shock Pulse group in terms of stone-free (p=0.037), CIRF (p=0.028), failure (p = 0.023). 5 Hammad Afzal Malik et al in their study in 2007 found a significant difference (p <0.05) in terms of stone clearance rate between Pneumatic (83%)and Laser (87%) group, as well as in terms of residual stone: Pneumatic (17%) and Laser (13%) group. 6 In our study mean stone clearance rate (mm 3 /min) in Laser, Pneumatic and Shock Pulse group: 16.91, 24.74, and 33.32 respectively.…”

Section: Resultsmentioning

confidence: 92%

A Comparative Study Between Holmium Laser, Pneumatic Lithotripsy and Shock Pulse in Terms of Efficacy and Safety in Percutaneous Nephrolithotomy (PCNL): A Prospective Randomized Study

Rajeev

Pratihar

Sarma

et al. 2020

Journal of Endoluminal Endourology

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Background and ObjectivesPercutaneous nephrolithotomy (PCNL) occupies an essential place in the treatment of upper urinary tract calculi. PCNL also accomplishes higher stone-free rates and requires fewer auxiliary procedures than shock wave lithotripsy (SWL) and ureterorenoscopy (URS) for renal stones between 1–2 cm. There are different intracorporeal lithotripter devices available. This study aims to compare the efficacy and safety of holmium laser, pneumatic lithotripsy and Shock Pulse in PCNL. Materials and MethodsA prospective randomized study was performed in Gauhati Medical College & Hospital, Guwahati, Assam, India, between October 2016 to November 2018. Patients of renal calculi and upper ureteric calculi less than or equal to 2.5cms and functioning kidney on the ipsilateral side were included. 300 patients were randomized according to a random number generator. In the holmium laser, pneumatic and Shock Pulse groups’ number of patients was 96, 102, 102 respectively. Stone disintegration time (SDT), stone-free rate, failure rate, success rate, irrigant used, mean hematocrit drop were evaluated. Statistical analysis was done to compare and predict any significant difference. ResultsPatients were divided into groups depending on the lithotripter used: group A (n=96), group B (n=102), group C (n=102) were holmium laser, pneumatic lithotripsy, and Shock Pulse respectively. No significant difference in stone location (p=0.785),Hounsfield unit (p=0.115),complication rates between the groups. Stone free rate in laser, pneumatic lithotripter, and Shock Pulse were 81.25%, 67.65%, 82.35% (highest in Shock Pulse and lowest in the Pneumatic group) and failure rate were 6.25%, 14.7%, 5.89% respectively. A significant difference was found in terms of stone-free, success rate, clinically insignificant residual fragments(CIRF)and failure rates between the groups(p<0.001). Irrigant requirement (litre/mm3) between the groups is statistically significant (p<0.001) with the highest in Shock Pulse and lowest in the Pneumatic group. Mean hematocrit drop: 4.19%, 4.20%, 5.46% in Laser, Pneumatic and Shock Pulse respectively. No significant difference between Laser and Pneumatic group (p=0.907), but in Shock Pulse group it is significantly higher. (p< 0.001) ConclusionEfficacy of energy sources used in PCNL for stone fragmentation vary in terms of stone clearance, failure rates, SDT, irrigant requirement and mean hematocrit drop. In our study, we found stone clearance signifi-cantly higher in Shock Pulse than Pneumatic and Laser groups. Stone fragmentation volume per unit time highest in Shock Pulse and lowest in Laser. Irrigant requirement highest in Shock Pulse group and compa-rable between Laser and Pneumatic group. The higher irrigant requirement in the Shock Pulse group may be the cause for higher hematocrit drop in this group. Complications between the groups are comparable.

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“…The combination of USL and PL in a lithotripter (dual-probe dual-modality) was expected to perform an additive effect, enhancing the efficacy of stone disintegration. Interestingly, the stone-free rate and safety of these combined lithotripters did not outweigh the USL [ 71 72 73 ]. The quest for a better lithotripter for PCNL continues.…”

Section: Resultsmentioning

confidence: 99%

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

Choi

et al. 2022

Investig Clin Urol

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This article aimed to review the clinical application and evidence of the therapeutic ultrasound in detail for urological diseases such as prostate cancer, kidney tumor, erectile dysfunction, and urolithiasis. We searched for articles about high-intensity focused ultrasound (HIFU), extracorporeal shock wave therapy, ultrasound lithotripsy, and extracorporeal shockwave lithotripsy (ESWL) in the MEDLINE and Embase. HIFU may be indicated as a primary treatment for low- or intermediate-risk prostate cancer, and salvage therapy for local recurrence as a promising way to address the limitations of current standard therapies. The application of HIFU in treating kidney tumors has scarcely been reported with unsatisfactory results. Evidence indicates that low-intensity shockwave therapy improves subjective and objective erectile function in patients with erectile dysfunction. Regarding the application of ultrasound in stone management, the novel combination of ultrasound lithotripsy and other energy sources in a single probe promises to be a game-changer in efficiently disintegrating large kidney stones in percutaneous nephrolithotomy. ESWL is losing its role in managing upper urinary tract calculi worldwide. The burst-wave lithotripsy and ultrasound propulsion could be the new hope to regain its position in the lithotripsy field. According to our investigations and reviews, cavitation bubbles of the therapeutic ultrasound are actively being used in the field of urology. Although clinical evidence has been accumulated in urological diseases such as prostate cancer, kidney tumor, erectile dysfunction, and lithotripsy, further development is needed to be a game-changer in treating these diseases.

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Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

Abstract: ARTICLE INfO

Cited by 11 publications

References 12 publications

The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

A Comparative Study Between Holmium Laser, Pneumatic Lithotripsy and Shock Pulse in Terms of Efficacy and Safety in Percutaneous Nephrolithotomy (PCNL): A Prospective Randomized Study

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

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