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Is newer always better? A comparative study of 3 lithotriptor generations
Rolf Gerber1, Urs E Studer, Hansjörg Danuser
1Department of Urology, University of Bern, Bern, Switzerland. rolf.gerber@hirslanden.ch
The Journal of Urology
|May 10, 2005
Summary
The HM3 lithotriptor demonstrated superior stone disintegration compared to LSP and SLX, leading to fewer complications and re-treatments. While initial stone-free rates varied, long-term outcomes were comparable across all three lithotriptor generations.
Area of Science:
- Urology
- Medical Devices
- Nephrology
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a primary treatment for kidney stones.
- Advancements in lithotriptor technology aim to improve stone fragmentation and reduce complications.
Purpose of the Study:
- To compare the efficacy of three generations of lithotriptors (HM3, LSP, SLX) in stone disintegration and pyelocaliceal system dilatation.
- To evaluate complication rates and re-treatment needs associated with each lithotriptor generation.
Main Methods:
- A prospective, randomized trial compared the HM3 and LSP lithotriptors.
- A matched, consecutive series of treatments with the Modulith SLX was included.
- Stone disintegration and pyelocaliceal system dilatation were assessed via X-ray and ultrasonography at 1 day and 3 months post-treatment.
Main Results:
- The HM3 lithotriptor achieved significantly higher stone-free rates (91%) on postoperative day 1 compared to LSP (65%) and SLX (48%).
- Re-treatment rates were lowest for HM3 (4%), followed by LSP (13%), and highest for SLX (38%).
- Despite initial differences, 3-month stone-free rates were comparable (HM3: 87%, LSP: 80%, SLX: 81%).
Conclusions:
- The HM3 lithotriptor offers superior stone disintegration for caliceal and renal pelvic stones compared to LSP and SLX.
- HM3 lithotripsy resulted in fewer complications and a lower need for re-treatments.
- LSP showed better performance than SLX in terms of stone disintegration and re-treatment rates.