Clinical application of Sonolith 3000 type on extracorporeal shock wave lithotripsy for renal and ureteral stones
Oka, T.; Hara, T.; Miyake, O.; Kobayashi, Y.; Yasunaga, Y.; Matsumiya, K.; Takaha, M.
Hinyokika Kiyo. Acta Urologica Japonica 36(10): 1203-1211
1990
ISSN/ISBN: 0018-1994 PMID: 2264549 Document Number: 351988
With Sonolith 3000, a new extracorporeal shock wave lithotriptor, we performed extracorporeal shock wave lithotripsy (ESWL) on 34 patients with upper urinary stones, including 5 patients with target stones of this clinical application in both sides. The 39 target stones in the 34 patients were located in the renal calyx (13 cases), renal pelvis (14 cases), renal calyx and pelvis (1 case), renal pelvis and ureter (1 case), and upper ureter (10 cases). The ultrasound-aiming system gave a satisfactory imaging of the target stones in 94.9% of cases (37/39 cases). During the ESWL treatment, 32 patients (94.2%) did not need anesthesia, but 2 patients (5.9%) needed epidural anesthesia because of intolerable pain and/or terror of pain. The average number of treatments per case was 2.08, and the average dose of shock waves per treatment was 3,691.1. The stone-free rate on the 14th, 42nd and 90th after the last ESWL treatment were 28.2% (11/39), 51.3% (20/39) and 64.1% (25/39), respectively. Out of 39 cases, 31 cases (79.5%) were either stone-free or had only sand-like residual stones on the 90th day. Most cases had minimal side effects, such as transient macroscopic hematuria (100.0%), skin eruption (50.0%) and back pain (41.2%), but one case needed, a 1,200 ml transfusion because of perirenal hematoma immediately after 1st session of ESWL treatment with 2,300 shock waves (13 kv). The serum total bilirubin level on 1st day after the last session of ESWL treatment was significantly increased when compared with the preoperative level, but the level was not significantly increased after the 1st session. This suggests that the damage caused by the shock waves to the red blood cells, muscle tissues and renal parenchyma may be increased with the increase in the number of sessions of ESWL treatment. Although we experienced one episode of perirenal hematoma, we believe that the Sonolith 3000 is useful as an extracorporeal shock wave lithotriptor for urolithiasis.