Comparison of electrohydraulic and electromagnetic extracorporeal shock wave lithotriptors for upper urinary tract...

To compare the efficacy and outcomes of shock wave lithotripsy (SWL) for upper urinary tract stones with an electrohydraulic (EH) and an electromagnetic (EM) lithotriptor in a single center.

The medical records of 272 patients with upper urinary tract stones ≤ 2 cm in size who underwent SWL with either the Medispec E3000 EH lithotriptor (179 cases) or the Medispec EM1000 EM lithotriptor (93 cases) were reviewed. The demographic data, stone parameters, stone-free rates, and retreatment rates were analyzed.

The EH group had a higher stone-free rate (53.6 vs. 30.1%, p < 0.001) and a lower retreatment rate (32.4 vs. 61.2%, p < 0.001) for renal and upper third ureteral stones than the EM group. The stone-free rates for renal stones < 1 cm (55.5 vs. 32.2%, p = 0.045), ureteral stones < 1 cm (64.5 vs. 42.1%, p = 0.028), and renal stones ≥ 1 cm (43.1 vs. 0%, p = 0.03) were higher in the EH group. Two patients in the EH group had a renal hematoma needing hospitalization after SWL. There were no complications in the EM group.

The Medispec E3000 EH lithotriptor had higher stone-free rates and lower retreatment rates than the Medispec EM1000 EM lithotriptor for renal stones < 2 cm and ureteral stones < 1 cm. Complications were rare.