Pressure-release versus rigid reflector for extracorporeal shockwave lithotripsy

Area of Science:

• Biomedical Engineering
• Urology
• Medical Physics

Background:

• Extracorporeal shockwave lithotripsy (SWL) is a common procedure for kidney stone treatment.
• Conventional rigid reflectors are used to focus shockwaves in electrohydraulic lithotripters.
• Improving the safety and efficacy of SWL remains an area of active research.

Purpose of the Study:

• To compare the performance of a novel pressure-release reflector against a traditional rigid reflector for shockwave concentration in SWL.
• To evaluate the advantages and disadvantages of each reflector type in terms of stone fragmentation and pressure dynamics.

Main Methods:

• A pressure-release reflector made of polyurethane foam was designed and tested.
• Shockwaves were generated using an electrohydraulic lithotripter with both reflector types.
• Kidney stone models were used to assess fragmentation, and pressure measurements were recorded.

Main Results:

• The pressure-release reflector resulted in less residual stone weight when fragments were screened through a 3.0 x 3.0-mm mesh.
• The rigid reflector achieved less residual fragment weight with smaller mesh sizes (1.0 x 1.0-mm and 0.6 x 0.6-mm).

Conclusions:

• Pressure-release reflectors offer a potential alternative for SWL, balancing stone fragmentation with enhanced patient safety.
• Further consideration of pressure-release reflectors in SWL devices is warranted.