“In Situ” Echo-Guided Extracorporeal Shock Wave Lithotripsy of Ureteral Stones:

Abstract

In 285 patients with prevesical ureteral stone and 247 with upper ureteral stone, extracorporeal shock wave lithotripsy (ESWL) was performed with the Dornier MPL 9000 ultrasonographic targeting device. All these stones were treated "in situ" and without regional or general anaesthesia. At 3-month follow-up 96.8% of the patients treated for prevesical stone and 95.5% of those with upper ureteral stone were stone-free. ESWL was repeated once or twice in 99 cases; the average number of sessions was 1.2 for all patients (similar for prevesical and upper ureteral stones). Sparse use of ureteral stenting (6.2% of cases) did not seem to reduce the efficacy of ESWL or increase complications or need for retreatment. Intravenous fentanyl analgesia was given to 40.9% of the patients and intravenous infusion of a furosemide solution was employed in many cases to give adequate dilation of the urinary tract. In situ echo-guided ureteral ESWL is simple, safe and efficacious and can be the technique of choice for sonographically detectable ureteral stone.

An Innovative Mobile Lithotripter for Extracorporeal Shock Wave Lithotripsy and Therapy

“…The fragmentation rate achieved with the device is well comparable with the data given in the recent literature [2]. As goes for the re-ESWL rate -compared to other studies [2,7,8] -the above-mentioned indication scheme and the following aspects have to be taken into consideration: If the plain X-ray 1 day after ESWL showed a fragmentation which could be improved, a second treatment was performed the next day. Besides that the in situ strategy is known to have a higher re-ESWL rate [9,10].…”

Postoperative Pain Management in Urology

“…Analgesic treatment is not wanted by 33-59% of patients who had shock wave lithotripsy (SWL) for urinary stone disease either during or after the procedure [19,20]. Generally pain after SWL procedure is not severe and oral treatments are sufficient.…”

In situ extracorporeal shock wave lithotripsy with Booster technique in the treatment of ureteral stones

“…Diesem Prinzip folgend behandeln wir seit mehr als 4 Jahren Harnleitersteine mit verschiedenen Lithotriptoren mittels "in situ" Behandlung [11,12,15,18,19,25,26], unter Verzicht auf 87 % der zuvor durchgeführten Auxiliärmaßnahmen. Diesem Prinzip folgend behandeln wir seit mehr als 4 Jahren Harnleitersteine mit verschiedenen Lithotriptoren mittels "in situ" Behandlung [11,12,15,18,19,25,26], unter Verzicht auf 87 % der zuvor durchgeführten Auxiliärmaßnahmen.…”