New Lithostar treatment technique for difficult upper ureteral stones

Area of Science:

• Urology
• Medical Devices
• Nephrolithiasis Treatment

Background:

• In situ treatment of ureteral stones using the Siemens Lithostar is generally effective.
• A subset of patients present challenges where stones overlie vertebral bone, hindering standard treatment.
• Conventional alternatives include delaying treatment or resorting to ureteroscopy or percutaneous manipulation.

Purpose of the Study:

• To describe and evaluate a novel technique for treating upper ureteral or lower pole renal stones that overlie vertebral bone during Siemens Lithostar treatment.
• To assess the efficacy of using the contralateral shock head with specific patient positioning to overcome bone interference.

Main Methods:

• A technique employing the contralateral shock head with stone side-posterior oblique positioning was utilized.
• This approach was applied to patients with upper ureteral or lower pole renal stones positioned over vertebral bone.
• Treatment outcomes were assessed at 3 months post-procedure.

Main Results:

• The described technique facilitated in situ Lithostar treatment in challenging cases.
• Nine out of ten patients (90%) achieved stone-free status at the 3-month follow-up.
• No additional treatments were required for the successful cases.

Conclusions:

• The contralateral shock head technique with posterior oblique positioning is an effective method for treating ureteral stones overlying bone.
• This approach offers a viable alternative to more invasive procedures for specific patient presentations.
• Successful stone clearance was achieved in the majority of treated patients.