A prospective randomised trial comparing the modified HM3 with the MODULITH® SLX-F2 lithotripter
Pascal Zehnder1, Beat Roth, Frédéric Birkhäuser
1Department of Urology, University of Bern, Bern, Switzerland.
European Urology
|February 8, 2011
Summary
The modified HM3 lithotripter demonstrated superior effectiveness in extracorporeal shock wave lithotripsy (ESWL), requiring fewer shock waves and leading to better stone-free rates for certain stone types compared to the MODULITH SLX-F2. This advanced lithotripter also resulted in fewer complications and secondary treatments.
Area of Science:
- Urology
- Nephrology
- Medical Devices
Background:
- The comparative efficacy of different generations of lithotripters for kidney stone treatment remains unclear.
- Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stone removal.
Purpose of the Study:
- To compare the clinical effectiveness and complication rates of the modified Dornier HM3 lithotripter against the MODULITH SLX-F2 lithotripter.
- To evaluate outcomes of ESWL using two distinct lithotripter technologies.
Main Methods:
- A prospective, randomized, single-institution trial was conducted.
- Patients underwent shock wave treatments under anesthesia.
- Outcomes including stone disintegration, residual fragments, collecting system dilatation, pain, hematoma, retreatments, and adjuvant procedures were assessed.
Main Results:
- The HM3 lithotripter required fewer shock waves and shorter fluoroscopy times.
- Higher stone-free rates at 3 months were observed with HM3 for solitary ureteral stones (90% vs. 81%) and multiple stones (64% vs. 44%).
- HM3 lithotripter resulted in fewer secondary treatments (11% vs. 19%) and kidney hematomas (1% vs. 3%).
Conclusions:
- The modified HM3 lithotripter is more effective than the MODULITH SLX-F2, particularly for ureteral and multiple stones.
- HM3 offers advantages in terms of reduced treatment parameters, fewer complications, and improved stone-free rates in specific patient groups.
- Comparable results were noted for solitary kidney and lower calyx stones.
