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[1 year's experience with the multifunctional lithotriptor Dornier MPL 9000]
Insights
The Dornier multipurpose lithotripter MPL 9000 effectively treated kidney stones in most patients, achieving high disintegration rates with minimal anesthesia. This extracorporeal shock wave lithotripsy (ESWL) method showed particular benefits for pediatric patients.
Area of Science:
- Urology
- Nephrology
- Medical Devices
Background:
- Kidney stones (renal calculi) are a common condition requiring effective treatment.
- Extracorporeal shock wave lithotripsy (ESWL) is a primary modality for stone management.
- The Dornier multipurpose lithotripter MPL 9000 is a specific ESWL device evaluated for efficacy and safety.
Purpose of the Study:
- To evaluate the effectiveness and safety of the Dornier multipurpose lithotripter MPL 9000 for treating renal and ureteral stones.
- To assess stone-free rates, fragmentation success, and complication incidence.
- To identify specific advantages, such as use without anesthesia and suitability for pediatric cases.
Main Methods:
- A retrospective analysis of 361 patients with 438 stones treated between March 1988 and May 1989.
- Utilized the Dornier multipurpose lithotripter MPL 9000.
- Recorded stone location, characteristics (including radiolucent stones), treatment details (anesthesia use, multiple sessions), fragmentation success, and follow-up stone-free status.
Main Results:
- High complete disintegration rate (95.7%) was achieved.
- 74.3% of patients were stone-free after 3 months.
- Most treatments (63.5%) were performed without analgesia or anesthesia; effective for renal stones but challenges noted for ureteral stones; no major complications.
Conclusions:
- The Dornier multipurpose lithotripter MPL 9000 is an effective treatment for renal stones, with a high success rate and minimal need for anesthesia.
- The device demonstrated particular advantages for treating children due to its focused shock wave delivery and ultrasound localization.
- While effective for renal calculi, localization difficulties were observed for ureteral stones.
Abstract:
From March 1988 until May 1989, 361 patients with 438 stones were treated with the Dornier multipurpose lithotripter MPL 9000. 64.8% of the stones were situated in the calyx, 32.6% in the renal pelvis, 1.1% in the upper and 1.4% in the distal ureter. 19.6% of the stones were radiolucent. Multiple MPL treatments were performed in 10.2%. In 4.3% fragments post-ESWL treatment were larger than 5 mm. In 95.7% of the cases complete disintegration was achieved. 63.5% of the treatments were performed without using analgesia or anesthesia. Intravenous anesthesia was used in 20.5%. Analgesia and sedation in 13.6%, general anesthesia in 1.7% and epidural anesthesia in 1.1%. After 3 months' follow up 74.3% were stone-free. Residual fragments were found in the upper calyx in 1%, in the middle calyx in 5%, in the lower calyx in 13%, in the renal pelvis in 5.6% and in the ureter in 1%. The MPL 9000 has been proven to be similarly effective for the treatment of renal stones, while difficulties in localizing ureteral stones, while difficulties in localizing ureteral stones were noted. The major number of treatment was performed without any analgesia or anesthesia. No major complications were encountered. Due to the small focal area and the ultrasound location system. Special advantages were found for the therapy of children.