Extracorporeal Shock Wave Lithotripsy for Urinary Stone Disease:
Clinical Experience with the Electromagnetic Lithotriptor ‘Lithostar’

Simon, Jonathan; Corbusier, A; Leal, A Mendes; Bossche, Matthias Van den; Wespes, Eric; Regemorter, G. Van; Schulman, Claude

doi:10.1159/000471519

Cited by 16 publications

(5 citation statements)

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“…With the advent of newer lithotriptors with flat, tubless operating tables and stone location systems combining fluoroscopy and ultrasonography, in situ ESWL treatment was greatly facilitated [1,6,14,15,17]. The prospect of avoiding any direct patient manipulation suddenly became very attractive, in particular as most of these lithotriptors are anesthesia-and even pain-free.…”

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confidence: 99%

ESWL in situ or ureteroscopy for ureteric stones?

et al. 1993

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As documented by follow-up data on ureteric stones in 1259 ureteric units treated, ESWL in situ on advanced lithotriptors with stone location by ultrasonography and fluoroscopy was successful without any retrograde ureteric manipulation in 98% of stones in the upper, 71% in the iliac, and 84% in the distal ureter; 85% of the units were stone-free within 3 months: ancillary measures were needed in 11% and the stone-free state was reached after a median of 39 days. The results obtained with treatment after manipulation of the stone from the upper and mid-ureter by retrograde instrumentation were similar, but ancillary measures were needed in 20% of cases. Endoscopic management with rod-lens ureteroscopes was highly efficient in the distal and mid-ureter, but involved a complication rate of about 11% and required general anaesthesia. In the upper ureter it was abandoned in favour of the two former methods. Endoscopic stone removal has been greatly facilitated by the development of ultrathin, semirigid ureteroscopes 6.2-9 F in diameter, as well as by laser and pneumatic lithotriptors that operate through their minute working ports. Of the stones impacted in 127 ureteric units, 97% were successfully managed at the first attempt, involving an overall complication rate of 6%.(ABSTRACT TRUNCATED AT 250 WORDS)

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confidence: 99%

ESWL in situ or ureteroscopy for ureteric stones?

et al. 1993

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“…Di-hydroxide calcium oxalate or magnesium ammonium-phosphate calculi are particularly fragile, while lower calyx stones often present elimination problems. [1][2][3][16][17][18][19][20][21][22] Papers dealing specifically with ESWL of calculi among spinal injury patients are rare. In a series of 32 patients treated with a DORNIER HM 3, Lazare reports success rates in the order of 90% for calculi…”

Section: Discussionmentioning

confidence: 99%

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients

et al. 1995

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, 15 spinal cord injury patients were treated by piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years (mean = 39), they presented with a total of 23 stones, of which 18 were located in the calyces, three in the renal pelvis and two in the proximal ureter. The maximum dimensions of calculi varied from 5 to 35 mm (mean = 11). Patients were placed in a dorsal decubitus position during the sessions, three being sedated with diazepam, while the other 12 remained unsedated.All were treated routinely with systemic antibiotics. Auxiliary procedures consisted of two pyelocalyceal flushings, three double J ureteral stenting and three ureteroscopies with fragment removal with a Dormia basket. No episode of autonomic dysreflexia was observed. Short term side effects were limited to a few cases of gross haematuria which regressed spontaneously. Overall, eight successes (53%), and seven failures (47%), were registered. Of the failures, one was the result of a partial fragmentation, while six were related to intrarenal retention of residual fragments resulting in four cases in rapid recurrences. Extracorporeal shock wave lithotripsy can be easily applied to spinal cord injury patients. Its usefulness and limitations need to be well understood and a global consideration must be applied to the prevention and early detection of the upper urinary calculi in this exposed population of patients.

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“…The peri-operative death rate in ESWL-treated patients was 0.02% (Chaussy, 1988) Of the 13 deaths reported in association with ESWL, only 3 appeared to be directly related to the procedure (Chaussy, 1988 ;Forssmann, 1990). Several cardiovascular complications, including arrhythmia, have been described with the first generation lithotriptors (Chaussy et al, 1984: Chaussy, 1986Drachetal., 1986;Lingeman, 1987: Lingeman andKulb, 1987;Lingeman et al, , 1989Politis and Griffith, 1987;Vallanciewn et al, 1988;Montgomery et al, 1989;Simon et al, 1989). Using the prototype Dornier lithotriptor, shock wave-dependent arrhythmia was observed in 80% of the patients (Chaussy et al, 1984).…”

Section: Discussionmentioning

confidence: 99%

“…Using the modified Dornier machine, Coptcoat et al (1986) treated 600 patients with urolithiasis, 5 of whom (1%) developed cardiac arrhythmia during treatment (4 ventricular tachycardia and 1 supraventricular tachycardia). In other series, 9 of 2475 patients (0.4%) (Simon et al, 1989) and 3 of 1060 patients (0.3%) had cardiovascular problems (Chaussy et al, 1984). Claymen et al (1988) reported 175 patients treated with the 5 cases (10%) was the arrhythmia noticed before treatment.…”

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confidence: 99%

Arrhythmia during Extracorporeal Shock Wave Lithotripsy

Zeng

Lindstedt

Roijer

et al. 1993

British Journal of Urology

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A prospective study of arrhythmia during extracorporeal shock wave lithotripsy (ESWL) was performed in 50 patients, using an EDAP LT01 piezoelectric lithotriptor. The 12-lead standard ECG was recorded continuously for 10 min before and during treatment. One or more atrial and/or ventricular ectopic beats occurred during ESWL in 15 cases (30%). The occurrence of arrhythmia was similar during right-sided and left-sided treatment. One patient developed multifocal ventricular premature beats and ventricular bigeminy; another had cardiac arrest for 13.5 s. It was found that various irregularities of the heart rhythm can be caused even by treatment with a lithotriptor using piezoelectric energy to create the shock wave. No evidence was found, however, that the shock wave itself rather than vagal activation and the action of sedo-analgesia was the cause of the arrhythmia. For patients with severe underlying heart disease and a history of complex arrhythmia, we suggest that the ECG be monitored during treatment. In other cases, we have found continuous monitoring of oxygen saturation and pulse rate with a pulse oximeter to be perfectly reliable for raising the alarm when depression of respiration and vaso-vagal reactions occur.

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Extracorporeal Shock Wave Lithotripsy for Urinary Stone Disease: Clinical Experience with the Electromagnetic Lithotriptor ‘Lithostar’

Cited by 16 publications

References 0 publications

ESWL in situ or ureteroscopy for ureteric stones?

ESWL in situ or ureteroscopy for ureteric stones?

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients

Arrhythmia during Extracorporeal Shock Wave Lithotripsy

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