Comparison between shockpulse and pneumatic lithotripsy in percutaneous nephrolithotomy.

Area of Science:

• Urology
• Nephrolithiasis Management
• Surgical Technology

Background:

• Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
• Lithotripsy devices are crucial for fragmenting stones during PCNL.
• Comparing novel devices to established ones is essential for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of shockpulse lithotripsy versus pneumatic lithotripsy in PCNL.
• To compare operative times, stone fragmentation efficiency, and complication rates between the two lithotripsy methods.

Main Methods:

• A prospective randomized comparative study involving 119 patients undergoing PCNL.
• Patients were divided into two groups: shockpulse (Group 1, n=61) and pneumatic lithoclast (Group 2, n=58).
• Key outcomes measured included operative duration, stone fragmentation time, stone-free rates, hemoglobin drop, hospital stay, and complications.

Main Results:

• No significant differences were observed in patient demographics, stone characteristics, hemoglobin drop, or hospital stay between groups.
• Stone-free rates were comparable: 78.69% for shockpulse and 74.13% for pneumatic lithotripsy.
• Shockpulse demonstrated significantly shorter mean stone fragmentation time (17.95 min vs 24.37 min) and total operation time (43.23 min vs 51.53 min).

Conclusions:

• Shockpulse lithotripsy is as effective and safe as pneumatic lithotripsy for PCNL.
• Shockpulse offers a significant advantage in reducing stone fragmentation and total operative time.
• These findings suggest shockpulse may be a more efficient option for PCNL stone treatment.