[Extracorporeal shock wave lithotripsy for upper urinary tract stone using piezoelectric lithotripter (Piezolith...

The results of clinical trial using the second generation extracorporeal shock wave lithotripter (Piezolith 2200, Wolf, West Germany) were presented. The treatments were performed between December 1987 and March 1988 at the University of Tokyo. In total 59 ESWL sessions were carried out on 32 patients with 48 upper urinary tract stones. The treatment could be performed without anesthesia or analgesic agent in every case. A double-J ureteral stent was indwelling in 6 patients with ureteral stones or large stones before ESWL treatment, and transurethral lithotripsy (TUL) was performed in two patients after the treatment. On the X-ray film obtained three weeks after the final ESWL treatment, 13 cases (40.6%) were completely free from stone fragments, while 9 cases (28.2%) had stone fragments less than or equal to 5 mm. Others had fragments greater than 5 mm. ESWL using this device was clinically useful in 71.9% in the three weeks follow-up period. No serious complication was observed after treatment except macroscopic hematuria for a few days in all cases, pyrexia in 4 cases (12.5%) and flank pain in 7 cases (21.9%). There were slight and transient changes in the laboratory data after the treatment, but these changes were milder than those with spark gap lithotripters. It is concluded that Piezolith 2200 is useful in the management of patients with upper urinary tract stones, and it is applicable more safely than the first generation lithotripters.