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Choosing a powerful lithotriptor
S F Mishriki1, N P Cohen, A C Baker
1Lithotriptor Unit, Southmead Hospital, Westbury-on-Trym, Bristol.
British Journal of Urology
|June 1, 1993
Summary
Choosing the best lithotriptor is challenging. This study identifies key acoustic output factors—pulse intensity integral and focal zone size—to objectively assess and compare lithotriptor power for efficient stone disintegration.
Area of Science:
- Biomedical Engineering
- Urology
- Medical Physics
Background:
- Clinicians lack objective criteria for selecting the most effective lithotriptor.
- Current selection relies on factors other than defined shock wave power.
- Efficient stone disintegration with minimal shocks and low re-treatment rates are clinical priorities.
Purpose of the Study:
- To define and measure the acoustic output power of commercial lithotriptors.
- To correlate acoustic measurements with in vitro stone disintegration capabilities.
- To establish objective parameters for comparing lithotriptor efficacy.
Main Methods:
- Acoustic output measurements were performed on three commercial lithotriptor systems: Dornier MPL 9000, Siemens Lithostar variants, and Wolf Piezolith 2300.
- Shock wave measurements included pulse intensity integral and focal zone size.
- In vitro disintegration of standard stone models was used to assess lithotriptor performance.
Main Results:
- The pulse intensity integral in the focus was identified as a critical factor.
- The size of the focal zone was found to be another key determinant of efficacy.
- These two factors together correlate with the ability to disintegrate stone models.
Conclusions:
- Pulse intensity integral and focal zone size are crucial for assessing lithotriptor power.
- These objective measures can guide clinicians in selecting the most efficient shock wave generating systems.
- Standardized acoustic measurements provide a yardstick for comparing lithotriptor performance.