Initial use of Browne Pneumatic Impactor

To determine the safety and effectiveness of the Browne Pneumatic Impactor (BPI), a new pneumatic mechanical lithotripter, in fragmenting urinary calculi. Nine patients were treated between November 1995 and March 1996. The calculi were located in the bladder and urethra in one case, the bladder alone in one case, the distal ureter in six cases, and the proximal ureter in one case. The device was used through semirigid and actively deflectable, flexible fiberoptic endoscopes. All patients were treated on an outpatient basis. Fragmentation of the urinary calculi was successful in all patients when the stone could be reached endoscopically. The device worked irrespective of stone size or composition. There were no intraoperative or long-term complications directly related to the use of the device. All treated patients were stone free at 1-month follow-up, with no evidence of ureteral obstruction. The results of our initial study show that the BPI is a simple, safe, and reliable intracorporeal lithotripter, able to fragment the hardest urinary calculi through semirigid and actively deflectable, flexible fiberoptic endoscopes with no complications related to use of the device.