Shockwave lithotripsy: instrumentation and status in China

Area of Science:

• Urology
• Biomedical Engineering
• Medical Device Technology

Background:

• Shockwave lithotripsy (SWL) is a common treatment for kidney stones.
• Technological advancements in lithotripters aim to improve efficacy and patient comfort.
• Chinese-manufactured lithotripters present unique technical characteristics compared to Western counterparts.

Purpose of the Study:

• To detail the physical background and technical features of Chinese lithotripters.
• To compare the effectiveness of SWL for distal ureteral stones using Chinese versus Western lithotripters.
• To evaluate the clinical outcomes of SWL in a stone center utilizing various lithotripter models.

Main Methods:

• A retrospective analysis of 1802 patients treated for distal ureteral stones between 1987 and 2003.
• Utilized four lithotripters: piezoelectric EDAP LT-01, Chinese electrohydraulic JDPN-IV, Western electromagnetic Dornier Compact S, and Chinese electromagnetic/electrohydraulic Huikang MZ-SWL-V.
• Treatment strategies remained consistent across all lithotripter series.

Main Results:

• The Chinese JDPN-IV (74%) and Huikang MZ-SWL-V (80%) showed higher efficiency quotients (EQ) than the EDAP LT-01 (69%).
• The Western Dornier Compact S achieved the highest EQ (81%), with a lower retreatment rate (12.9%).
• Chinese lithotripters, particularly JDPN-IV, demonstrated lower retreatment and auxiliary procedure rates compared to EDAP LT-01.

Conclusions:

• Chinese electrohydraulic and electromagnetic lithotripters offer superior stone fragmentation compared to the piezoelectric EDAP LT-01.
• While the Dornier Compact S shows higher fragmentation efficacy, Chinese lithotripters are associated with reduced patient pain.
• The study highlights the evolving capabilities of Chinese lithotripter technology in treating distal ureteral stones.