[Clinical application of Sonolith 2000 type B on extracorporeal shock wave lithotripsy for upper urinary tract...

This report describes the results of clinical trials of the second generation extracorporeal shock wave lithotriptor (Sonolith 2000 Type B) in patients with upper urinary tract stones. The studies were carried out on 101 cases at the Departments of Urology, Juntendo University School of Medicine, Kanto Teishin Hospital and General Daiyukai Hospital from Nov. 1987 to Jun. 1988. The location of stones were renal calyx and pelvis in 84 cases, ureteropelvic junction in 7 cases and upper ureter in 12 cases (2 of them had multiple stones at different levels). The average number of treatment per a patient was 1.25, and that of shock waves delivered per treatment was 1798. Ultrasound localization has been effective in all cases. The rate of destruction of the stones was 100% in the kidney, 66.7% in the upper ureter, with an overall average of 95.0%. On the X-ray film obtained six weeks after ESWL treatment, the stone free rate was 53.5%, and the effectiveness rate was 89.1%, including the cases of stone free and cases with fragments smaller than 5 mm. No serious adverse effect was observed, although there were mild transient hematuria in all cases and pyrexia (more than 38.0 degrees C) in 7 cases (6.9%). The procedure was performed safely in the majority of patients without anesthesia. In 10 cases, we applied anesthesia (epidural anesthesia in 3 cases, and local anesthesia in 7 cases) for the prevention of pain. It is concluded that ESWL treatment using Sonolith 2000 Type B is as effective as other types of shock wave lithotriptor previously applied to urolithiasis without serious clinical complication.