Clinical Experience of Extracorporeal Shock Wave Lithotripsy with Tripter Compact(R) Lithotriptor.
- Author:
Young Hwa YOON
1
;
Sam Keuk NAM
;
Soon Chan KIM
Author Information
1. Department of Urology, Seoul Advantist Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Urinary stone;
Shock wave lithotripsy
- MeSH:
Analgesics;
Female;
Hematuria;
Humans;
Lithotripsy*;
Male;
Retrospective Studies;
Shock*;
Ureter;
Urinary Calculi
- From:Korean Journal of Urology
1999;40(5):537-541
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Extracorporeal shock wave lithotripsy(SWL) is currently prorposed for the first line treatment of most renal and ureteral stones. In general, SWL is very effective and non-invasive method than open surgery or endoscopic lithotripsy. We experienced 350 cases of SWL for 46 months and announced it. MATERIALS AND METHODS: We retrospectively reviewed the data of 324 patients(350 stones) who had been diagnosed as renal or ureteral stones and underwent SWL using Tripter Compact(R) lithotriptor from September 1994 to July 1998. Male to female ratio was 1.9:1 and patient`s ages ranged from 18 to 82 years(mean 43.7 years). We underwent SWL only with parenteral analgesics for pain control. RESULTS: In 350 stones, renal stones were 90 cases(25.7%) and ureteral stones were 260 cases(74.3%). In 90 renal stones, calyceal stones(include 1 staghorn stone) were 62 cases(68.9%) and renal pelvic stones were 28 cases(31.1%). In 260 ureteral stones, upper ureteral stones were 209 cases(80.4%), mid ureteral stones were 10 cases(3.8%), and lower ureteral stones were 41 cases(15.8%). The stones from 10 to 19mm in diameter were the majority of renal stones(53.3%), whereas in ureter, the stones smaller than 10mm in diameter were most common(41.5%). Less than 3 treatment sessions were needed for 147 cases(93.0%) of stones smaller than 10mm and for 146cases(76.0%) stones larger than 10mm. Less than 3 sessions were needed for 68 cases(75.6%) of renal stones and for 225 cases(86.5%) of ureteral stones. All renal stones were fragmented and the success rate for upper ureteral stones was 93.3%(195/209), for mid ureteral stones was 80.0%(8/10), and for lower ureteral stones was 80.5%(33/41). According to the size of stone, the success rate for the stones smaller than 10mm in diameter was 96.2%(152/158) and for the stones larger than 10mm was 90.6%(174/192). Total success rate was 93.1%(326/350). The complications after SWL were gross hematuria over 24hours(64 cases, 18.3%), flank pain(52 cases, 14.9%), gastrointestinal disturbances(7 cases, 2%), and Steinstrasse(31 cases, 8.9%). The causes of failure were incomplete fragmentation(21 cases, 87.5%) and mucosal impact(3 cases, 12.5%) of stones. Re-treatment rate was 59.7% and auxiliary procedure rate was 8.0%(efficiency quotient was 0.56). CONCLUSIONS: Our experiences shows extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of renal and ureteral stones, and we expect the better outcome by development of techniques and equipments.
