Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

Mustafa, Mahmoud; Aburas, Honood; Helo, Fatima M.; Qarawi, Lailah

doi:10.1089/end.2016.0644

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…A possible limitation of the study is on the part of the operator: although all the centers have a high level of expertise, US targeting was performed by a single operator No significant differences in efficacy were demonstrated with the use of an electrohydraulic, electroconductive, and electromagnetic lithotripter, which is in agreement with the results of several studies [6][7] . However, a significant difference was observed when analgesic consumption was compared: it was significantly higher in the electrohydraulic type than in the electromagnetic generator type with fluoroscopy guidance.…”

Section: Discussionsupporting

confidence: 81%

Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy

Motolová¹,

Král²

2022

BIOMED PAP

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Objective. Analysis of the effect of technical factors, i.e. the type of stone targeting and shock wave generator, on ESWL efficacy. Evaluation of secondary outcomes to determine an optimal strategy for performing the procedure. Patients and Method. In the period from 01/2016 to 07/2021, we analyzed data from patients indicated for ESWL for nephrolithiasis and proximal or distal ureterolithiasis. This was a tricenter retrospective study to evaluate stone-free rates (SFR) while taking into account the number of ESWL sessions in four selected groups of patients with comparable characteristics. A patient is considered stone-free in the absence of residual lithiasis or with an asymptomatic residue of up to 2 mm. The real-time ultrasound-guided (USG) arm consisted of a group of 120 patients on the electromagnetic STORZ SLK lithotripter in the period from 02/2017 to 02/2020. A total of three comparison arms with x-ray guidance were created: A: 68 patients between 01/2016 and 03/2017 on the Medilit 7 electrohydraulic lithotripter. B: 72 patients from 04/2017 to 10/2017 on the Sonolith i-sys electroconductive lithotripter (EDAP). C: 120 patients from 03/2018 to 07/2021 on the STORZ SLK electromagnetic lithotripter. By comparing the US and x-ray guidance using the STORZ SLK lithotripter, the effect of targeting when using an identical device (electromagnetic generator) was evaluated. By comparing the arms A, B, and C, the efficacy in different types of generators -electromagnetic, electroconductive, electrohydraulic -was assessed when the same type of targeting (fluoroscopy) was used. The secondary parameters that were monitored included: the rate of use of auxiliary techniques in stone management; radiation exposure for the patient and/or operator; analgesic consumption; and the time required to perform the procedure. Results. When US versus x-ray guidance was compared in an electromagnetic lithotripter, SFRs of 90% vs. 85% (P=0.329), i.e. statistically comparable results, were obtained. By comparing electromagnetic, electroconductive, and electrohydraulic generators with fluoroscopy, SFRs of 85%, 88.9%, and 88.2% were obtained, respectively (P=0.727). When the degree of need for intraoperative analgesic administration was assessed, the electromagnetic generator was found to have a significantly lower consumption (20.8% vs. 30.6% vs. 48.5%) (P=0.0005). Values less than 1095 HU and 108.5 mm were shown to be optimal cut-off values for stone density and skin-to-stone distance, respectively. Conclusion. Based on our comparative analysis, the noninferiority of US stone targeting was demonstrated compared to fluoroscopic targeting. No significant differences in ESWL efficacy were found using electrohydraulic, electroconductive or electromagnetic shock wave generators. With the electromagnetic lithotripter, there was a significantly lower analgesic consumption than with the electrohydraulic type.

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Section: Discussionsupporting

confidence: 81%

Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy

Motolová¹,

Král²

2022

BIOMED PAP

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“…In another human study comparing electromagnetic versus electrohydraulic lithotriptors, it has been reported that electromagnetic lithotriptor caused higher number of red blood cells in the urine compared to electrohydraulic lithotriptor in the early post-SWL period. However, cytologic evaluations performed 10 days after SWL therapy showed recovery of all abnormal cytologic findings (10). On the other hand, an intraparenchymal, subcapsular and perirenal hematoma is another well-known ESWL-induced acute renal complication.…”

Section: Discussionmentioning

confidence: 99%

Protective Effects of Oral Sirolimus Therapy against ESWL-induced Kidney Tissue Damage in Rats

Mercimek¹,

Bostanci²,

Özden³

et al. 2019

jus

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Amaç: Bu çalışmada, deneysel rat modelinde oral sirolimus tedavisinin ekstrakorporeal şok dalgası tedavisi (ESWL) sonrası oluşabilecek böbrek dokusu hasarı üzerine kısa ve uzun dönemde koruyucu etkilerini araştırmayı amaçladık. Gereç ve Yöntem: Bu çalışmada 24 erkek Spraque-Dawley rat kullanıldı. Tüm ratların sol böbreğine 15 kV, 60 SW/dk'da toplam 1000 şok dalgası uyguladı. İki ana grup, ESWL (grup 1) ve ESWL sirolimus (grup 2) oluşturuldu. Her grup erken (E) ve geç (L) olmak üzere iki alt gruba ayrıldı. Sol nefrektomi 15. günde E gruplara, 60. günde L gruplara yapıldı. Tübüler hasar, interstisyel değişiklikler ve skar oluşumu, her denekte en az 10 kortikal alanı için yarı kantitatif olarak skorlandı. Her denek için ortalama bir puan hesaplandı. İstatistiksel analiz için bağımsız örneklem t-testi kullanıldı. İstatistiksel anlamlılık p<0,05 olarak kabul edildi. Objective: In the present study, we aimed to investigate the short-and long-term protective effects of oral sirolimus therapy on extracorporeal shock wave lithotripsy (ESWL)-induced kidney tissue damage in an experimental rat model. Materials and Methods: Twenty-four male Spraque-Dawley rats were used in the study. A total of 1000 shock waves (SWs) were applied to the left kidney of all rats at 15 kV, 60 SW/min. Two main groups, ESWL (group 1) and ESWL sirolimus (group 2), were formed. Each group was divided into two subgroups as early (E) and late (L). Left nephrectomy was performed on the 15 th day in E groups and on the 60 th day in L groups. Tubular injury, interstitial changes, as well as scar formation, were scored semi-quantitatively for at least 10 cortical fields in each sample. An average score was calculated for each subject. Independent samples t-test was used for statistical analysis. The statistical significance was accepted as p<0.05. Results: The mean histopathological score was 0.08±0.94 and 0.15±0.65 (p=0.332) in group 1E and 2E and it was 0.27±0.17 in group 1L and 0.05±0.06 in group 2L, respectively (p<0.05). When group 1E and group 1L were compared, the mean score was 0.08±0.94 and 0.27±0.17, respectively (p<0.05). Furthermore, there was also a statistically significant difference in mean histopathological score between group 2E and group 2L. The mean score was 0.15±0.65 vs 0.05±0.06 (p<0.05). Conclusion: Depending on SW power and frequency, ESWL may cause significant histopathological changes in rat kidneys in the chronic period. In this experimental study, it has been thought that sirolimus treatment may have a tissue protective effect against long-term renal tissue damage.

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“…While several studies have compared the efficacies of electrohydraulic and electromagnetic ESWT for treating ureter stones, the results obtained with the 2 types of generators were not significantly different [ 29 30 ]. However, we anticipate that electromagnetic ESWT will be found to have theoretical advantages that could be applicable in clinical practice in the future.…”

Section: Discussionmentioning

confidence: 99%

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

Jeong

Jeon

Zhu

et al. 2017

World J Mens Health

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PurposeGene therapy, stem cell therapy, and low-energy extracorporeal shockwave therapy (ESWT) have been investigated as treatments for refractory erectile dysfunction (ED), but inconclusive evidence has been obtained. We investigated the effect of a next-generation electromagnetic cylinder ESWT device on an animal model of ED.Materials and MethodsDiabetes mellitus (DM)-induced rats were divided into 3 groups: group 1, control; group 2, DM; and group 3, DM+ESWT. Rats were treated with ESWT 3 times a week for 2 weeks. After the treatment course, intracavernous pressure was measured and the corpus cavernosum and cavernous nerve were evaluated.ResultsIn the DM group, all parameters predicted to be significantly lower in the ED model had statistically significantly decreased (p<0.01). As a measurement of erectile function, intracavernous pressure was evaluated. The DM+ESWT group exhibited significantly restored erectile function compared to the DM group (p<0.05). Moreover, ESWT treatment restored smooth muscle content, as assessed by Masson's trichrome staining (p<0.05). Finally, corporal tissue and the dorsal nerve were evaluated by immunohistochemistry, Western blotting, and ELISA. After ESWT treatment, vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), platelet endothelial cell adhesion molecule-1, cyclic guanosine monophosphate, and neuronal nitric oxide synthase (nNOS) expression levels were restored to levels in the DM group (p<0.05).ConclusionsElectromagnetic cylinder ESWT device resulted in increased VEGF, nNOS, and eNOS expression; reduced smooth muscle atrophy; and increased endothelial cell regeneration in a DM-associated ED model. Our data suggest that safe and effective application could be possible in future clinical studies.

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Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

Cited by 9 publications

References 28 publications

Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy

Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy

Protective Effects of Oral Sirolimus Therapy against ESWL-induced Kidney Tissue Damage in Rats

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

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