[Extracorporeal shockwave lithotripsy 5 years on]

Investigations initiated in the Research Urological Institute headed by professor N. A. Lopatkin in 1984 on development of an original Russian lithotriptor URAT-II were successfully finished in 1987. Since that time the design has been advanced. The investigators plan to introduce a novel polyfunctional lithotriptor ARKO-LIT with double guidance system and several impulse heads. The unit is to have various forms of impulse generation and diverse physical parameters. When equipped with water cushion, the new lithotriptor will enable the physician to do endoscopic, x-ray diagnostic and therapeutic manipulations. It is emphasized that the main thing in prevention of lithotripsy complications is proper management of the apparatuses which implies sufficient knowledge of the impulse physics and impulse interaction with biologically active tissues. As for cell impairment, lipid peroxidation evaluation suggests that under adequate selection and performance of the procedure as well as proper preoperative preparation, changes in cell membranes are moderate and disappear within 7 posttreatment days. In case of underestimation of the patient's condition, renal function, in violation of the stone destruction technique the above changes may advance to serious and entail severe complications.