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Suboptimal treatment results with the Therasonics lithotriptor
J B Robertson1, M O Koch, F K Kirchner
1Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765.
The Journal of Urology
|August 1, 1994
Summary
The Therasonics lithotriptor showed a 49% success rate for kidney stone treatment, with a high 63% retreatment rate. Pain and technical issues frequently interrupted procedures, suggesting potential limitations compared to other devices.
Area of Science:
- Urology
- Medical Devices
- Nephrology
Background:
- Kidney stones (nephrolithiasis) are a common condition requiring effective treatment.
- Extracorporeal shock wave lithotripsy (ESWL) is a primary modality for stone fragmentation.
- Evaluating the efficacy and safety of specific lithotriptor devices is crucial for clinical practice.
Purpose of the Study:
- To assess the clinical outcomes of the Therasonics lithotriptor for kidney stone treatment.
- To determine the success rate, retreatment rate, and complication profile of this specific device.
- To compare the performance of the Therasonics lithotriptor with other available lithotripsy technologies.
Main Methods:
- A retrospective analysis of 174 stone treatments performed on 112 stones in 86 patients.
- Utilized the Therasonics lithotriptor for stone fragmentation, with a mean stone diameter of 13 mm.
- Success defined as asymptomatic patients with no stone debris or fragments larger than 4 mm.
Main Results:
- Achieved a success rate of 49% and a high retreatment rate of 63%.
- Moderate to severe pain occurred in 42% of treatments, despite narcotic and anxiolytic sedation.
- 13% of treatments were aborted due to pain or technical difficulties in patient positioning and stone localization.
Conclusions:
- The Therasonics lithotriptor demonstrated suboptimal efficacy and a significant complication rate in this patient cohort.
- Results suggest that the Therasonics system may be inferior to alternative lithotriptors currently available.
- Potential system modifications could improve stone localization and treatment outcomes, warranting further investigation.