Extracorporeal shock wave lithotripsy monotherapy for bladder stones with the second generation lithotriptors

Between June 1987 and April 1989 a total of 4,500 extracorporeal shock wave lithotripsy treatments was performed in our department with the Siemens Lithostar lithotriptor. Renal (pelvic, caliceal and staghorn stones), ureteral and even bladder calculi can be treated by means of a system of fluoroscopic detection and electromagnetic shock wave generation. The treatments are performed without the use of anesthesia and on an outpatient basis. Hospitalization is indicated whenever underlying infectious stone disorders are suspected (associated urinary tract infection or infected calculi). Initial experience in the first 10 patients with bladder stones treated by electromagnetic extracorporeal shock wave lithotripsy monotherapy is reported. All stones disintegrated after 1 treatment, except in a patient with 2 bladder stones who required 2 sessions. Mean treatment duration was 53 minutes. Mean number of shock waves was 3,600 and electrical discharge averaged 20.2 kv. per shock wave. Minute fragmentation was obtained and uncomplicated evacuation occurred without the need for adjuvant procedures, even in the presence of prostatic hypertrophy (2 patients) or neurogenic bladder dysfunction (3). No morbidity during or after treatment was encountered in these 10 patients.