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Failure after shockwave lithotripsy: is outcome machine dependent?

A N Argyropoulos¹, D A Tolley

¹Department of Urology, The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UK.

International Journal of Clinical Practice

|June 4, 2009

Summary

This summary is machine-generated.

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Switching lithotripter machines can overcome extracorporeal shockwave lithotripsy (ESWL) failure. Stones previously resistant to one machine showed improved success rates with a different lithotriptor, suggesting machine characteristics impact outcomes.

Area of Science:

Urology
Nephrology
Medical Engineering

Background:

Extracorporeal shockwave lithotripsy (ESWL) is a common treatment for renal stones.
Treatment failure can occur, leading to the concept of 'ESWL-resistant stones'.

Purpose of the Study:

To evaluate the efficacy of switching to the Technomed Sonolith Vision (TSV) lithotriptor for patients with renal stones previously treated unsuccessfully with the Dornier Compact Delta (DCD).
To investigate if machine crossover impacts stone-free rates (SFR) and overall success rates (SR).

Main Methods:

Retrospective analysis of 76 patients treated between 1998 and 2006.
Comparison of stone characteristics (size, multiplicity, location) and treatment outcomes before and after machine crossover.
Subgroup analysis of 42 patients with similar pre-treatment stone sizes.

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Main Results:

The TSV achieved a 56.7% stone-free rate (SFR) and an 86.7% success rate (SR) at 3 months.
In a subgroup of 42 patients, the SFR was 61.9% and SR was 88.1% after switching to TSV.
No significant difference in SFR was observed for single versus multiple stones across both lithotriptor groups.

Conclusions:

The notion of 'ESWL-resistant stones' may require re-evaluation, as different lithotriptors yield varying success rates.
Lithotripters with distinct shock wave properties influence ESWL outcomes.
Future ESWL research should prioritize stone characteristics and the development of adaptable lithotripter technology.