Piezolithotripsy: Experience with the Wolf Piezolith 2300
The North East Thames Regional lithotripter service was commissioned in December 1987 to treat patients with the Wolf Piezolith 2300. To December 1988 518 patients were treated with piezoelectric lithotripsy (PEL) on a second-generation device with a total of 1,612 treatments (average 3.1). Follow-up data were available on 447 patients (85%). Of these, 323 patients (62%) had completed treatment. All treatments were performed on an outpatient, ambulatory basis unless coexisting medical problems (10 patients, 2%) required admission or the patient lived excessively far away (21.4%). Twenty-six patients (7%) underwent preliminary percutaneous stone surgery to debulk staghom calculi, and 74 patients (17%) required endoscopic retrograde manipulation of ureteric stones and placement of a ureteral stent (7%) or the insertion of double-J stents prior to treatment of stones larger than 2 cm in diameter. Up to 4,000 shock waves were given per treatment, which took approximately 55 minutes overall.
Overall, 254 of 447 patients (57%) were deemed stone free. However, 78% of 323 patients who have completed planned treatment became stone free. One hundred ten patients (25%) have fragments 2 mm or smaller. Eighty-three patients (17%) have fragments larger than 2 mm However, those patients who are considered stone free or who have fragments 2 mm or smaller generally do not require further treatment. These patients comprise 83% of those with follow-up data.
The Piezolith 2300 allows efficient, effective, painless, outpatient therapy for most patients with upper urinary tract stones. Most patients will require more than one PEL session, which should be taken into account when planning treatment.
KeywordsShock Wave Shock Wave Lithotripsy Extracorporeal Shock Wave Lithotripsy Ureteric Stone Urinary Tract Stone
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- 2.Webb DR, McNicholas TA, Whitfield HN, et al: ESWL, endourology and open surgery: the management and follow-up of 200 patients with urinary calculi. Ann Roy Coll Surg Engl 67: 337, 1985.Google Scholar