Portal de Periódicos da CAPES

EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY: A COMPARATIVE STUDY OF ELECTROHYDRAULIC AND ELECTROMAGNETIC UNITS

2001; Lippincott Williams & Wilkins; Volume: 166; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)65504-8

1527-3792

Surena F. Matin, Agnes Yost, Stevan B. Streem,

Gallbladder and Bile Duct Disorders

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2001EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY: A COMPARATIVE STUDY OF ELECTROHYDRAULIC AND ELECTROMAGNETIC UNITS SURENA F. MATIN, AGNES YOST, and STEVAN B. STREEM SURENA F. MATINSURENA F. MATIN More articles by this author , AGNES YOSTAGNES YOST More articles by this author , and STEVAN B. STREEMSTEVAN B. STREEM More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65504-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the results of shock wave lithotripsy with a newer electromagnetic lithotriptor and compared them with those in a contemporary series of cases managed by an electrohydraulic lithotriptor using identical treatment and followup criteria at a single center. Materials and Methods: Between 1995 and 1999, 356 patients (375 renal units, 483 upper urinary tract stones) meeting study inclusion criteria were treated with an MFL 5000 electrohydraulic shock wave lithotripsy unit (Dornier Medical Systems, Inc., Marietta, Georgia). From 1999 to 2000, 173 patients (175 renal units; 218 upper urinary tract stones) meeting identical study inclusion criteria were treated using an electromagnetic Modulith SLX shock wave lithotripsy unit (Karl Storz Lithotripsy, Atlanta, Georgia). In each group stone-free results were determined by plain abdominal x-ray and renal ultrasound 1 month after lithotripsy and efficiency quotients were developed. Baseline patient and stone characteristics were compared by the Wilcoxon rank sum and Fisher exact tests. All variables significant at p <0.05 were included in subsequent outcome analysis using multivariate logistic regression. Results: Baseline characteristics were equivalent, including patient age, gender, stone number and location, although patients treated with the electrohydraulic unit had a significantly larger median stone burden (103 versus 71 mm.2, p = 0.015). Multivariate regression analysis demonstrated a higher stone-free rate in the electrohydraulic group (77% versus 67%, p = 0.01) but also a higher rate of total adjunctive measures (56% versus 47%, p = 0.04). Consequently the efficiency quotients were comparable for the electrohydraulic and electromagnetic lithotripsy units (0.45 and 0.42, respectively, p = 0.43). Conclusions: Electrohydraulic lithotripsy resulted in a higher stone-free rate at 1 month, although it was associated with a higher rate of auxiliary measures. Ultimately the efficiency quotients were equivalent, implying that these 2 contemporary energy sources are acceptable. According to single center treatment and followup criteria they are equally efficacious. References 1 : Extracorporeal shock wave lithotripsy for the treatment of urinary calculi. In: Adult and Pediatric Urology. Edited by . St. Louis: Mosby1996: 913. Google Scholar 2 : A prospective trial comparing the efficacy and complications of the modified Dornier HM3 and MFL 5000 lithotriptors for solitary renal calculi. J Urol1995; 153: 1794. Link, Google Scholar 3 : Primary in-situ extracorporeal shock-wave lithotripsy in the management of ureteric calculi: results with a third-generation lithotripter. BJU Int1999; 84: 770. Google Scholar 4 : Extracorporeal shock-wave lithotripsy: multicenter study of kidney and upper ureter versus middle and lower ureter treatments. J Urol1994; 152: 1379. Abstract, Google Scholar 5 : Dornier MFL 5000 and compact lithotriptors. Semin Urol1991; 9: 225. Google Scholar 6 : Shock wave lithotripsy with the Dornier MFL 5000 lithotriptor using an external fixed-rate signal. J Urol1995; 154: 951. Link, Google Scholar 7 : Reassessing the efficacy of the Dornier MFL-5000 lithotriptor. J Urol2000; 164: 640. Abstract, Google Scholar 8 : Comparison of mobile lithotripters at one institution: Healthtronics Lithotron, Dornier MFL-5000, and Dornier Doli. J Endourol1999; 13: 539. Google Scholar 9 : Extracorporeal shock wave lithotripsy with the Storz Modulith SL20: the first 500 patients. Br J Urol1992; 69: 465. Google Scholar 10 : The clinical introduction of the third generation lithotriptor: Modulith SL20. J Urol1995; 153: 1379. Link, Google Scholar 11 : Efficacy quotient as a means of comparing lithotripters. J Endourol, suppl.1990; 4: 100. Google Scholar 12 Modulith SLX Operating Manual. Kreuzlingen, Switzerland: Storz Medical, 1996 Google Scholar 13 : Dornier MFL 5000 and compact lithotriptors. Semin Urol1991; 9: 225. Google Scholar 14 : A prospective analysis of new, refurbished and twice refurbished electrodes for the Dornier MFL 5000. Br J Urol, suppl.1997; 80: 334. Google Scholar 15 : Editorial comment. J Urol2000; 164: 643. Google Scholar 16 : Variation in clinical outcome following shock wave lithotripsy. J Urol2000; 163: 721. Google Scholar 17 : Comparison of first generation (Dornier HM3) and second generation (Medstone STS) lithotriptors: treatment results with 13,864 renal and ureteral calculi. J Urol1995; 153: 588. Link, Google Scholar 18 : Prospective randomized trial to compare a first- to a second generation lithotriptor in solitary kidney stones. Br J Urol, suppl.1997; 80: 334. Google Scholar 19 : Consecutive experience with four Dornier lithotripters: HM4, MPL 9000, compact, and U/50. J Endourol1999; 13: 329. Google Scholar 20 : In vitro comparison of shock wave lithotripsy machines. J Urol2000; 164: 1259. Link, Google Scholar From the Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAlanee S, Ugarte R and Monga M (2018) The Effectiveness of Shock Wave Lithotripters: A Case Matched ComparisonJournal of Urology, VOL. 184, NO. 6, (2364-2367), Online publication date: 1-Dec-2010.Micali S, Sighinolfi M, Celia A, De Stefani S, Grande M, Cicero A and Bianchi G (2018) Can Phyllanthus niruri Affect the Efficacy of Extracorporeal Shock Wave Lithotripsy for Renal Stones? A Randomized, Prospective, Long-Term StudyJournal of Urology, VOL. 176, NO. 3, (1020-1022), Online publication date: 1-Sep-2006.Pishchalnikov Y, Neucks J, VonDerHaar R, Pishchalnikova I, Williams J and McAteer J (2018) Air Pockets Trapped During Routine Coupling in Dry Head Lithotripsy Can Significantly Decrease the Delivery of Shock Wave EnergyJournal of Urology, VOL. 176, NO. 6, (2706-2710), Online publication date: 1-Dec-2006.GERBER R, STUDER U and DANUSER H (2018) IS NEWER ALWAYS BETTER? A COMPARATIVE STUDY OF 3 LITHOTRIPTOR GENERATIONSJournal of Urology, VOL. 173, NO. 6, (2013-2016), Online publication date: 1-Jun-2005.DHAR N, THORNTON J, KARAFA M and STREEM S (2018) A MULTIVARIATE ANALYSIS OF RISK FACTORS ASSOCIATED WITH SUBCAPSULAR HEMATOMA FORMATION FOLLOWING ELECTROMAGNETIC SHOCK WAVE LITHOTRIPSYJournal of Urology, VOL. 172, NO. 6 Part 1, (2271-2274), Online publication date: 1-Dec-2004.SHEIR K, MADBOULY K and ELSOBKY E (2018) Prospective Randomized Comparative Study of the Effectiveness and Safety of Electrohydraulic and Electromagnetic Extracorporeal Shock Wave LithotriptorsJournal of Urology, VOL. 170, NO. 2, (389-392), Online publication date: 1-Aug-2003. Volume 166Issue 6December 2001Page: 2053-2056 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsurinary calculielectromagneticslithotripsyurinary tractMetricsAuthor Information SURENA F. MATIN More articles by this author AGNES YOST More articles by this author STEVAN B. STREEM More articles by this author Expand All Advertisement PDF downloadLoading ...