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

Abstract

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.

Comparison of an electromagnetic and an electrohydraulic lithotripter: Efficacy, pain and complications

“…In literature there are many studies that compare different lithotripters. Some studies evaluate, as we did, the differences between electrohydraulic and electromagnetic lithotripters, however, the results are discordant (3,4). In our series electromagnetic lithotripter has better results.…”

“…tially the same way (2). Many studies compare different lithotripters or different energy source in order to evaluate efficacy (3,4). In our institution, we used an electrohydraulic lithotripter and when it was no longer available, we used an electromagnetic one.…”

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

“…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.…”

Minimally invasive surgery for pediatric renal and ureteric stones: A therapeutic update

“…Currently, several types of shock wave generation are available, including electrohydraulic, electromagnetic, and piezoelectric ( 13 ). It was reported that there was no significant difference in treatment outcomes between electromagnetic and electrohydraulic methods ( 14 ). According to the results from both clinical and experimental researches, the commended shockwave frequency for PU is 60/min (1 Hz) ( 15 ).…”