Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter

Stojanoski, Ivica and Krstev, Toni and Ilievski, Lazar and Tufekgioski, Nerhim and Stavridis, Sotir (2020) Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter. Open Access Macedonian Journal of Medical Sciences., 8 (B). pp. 851-857. ISSN 1857-9655

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Abstract

BACKGROUND: The extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method in the treatment of
urinary tract stones and its discovery has led to a complete change in the therapeutic strategy for urolithiasis. Due to
the low morbidity and excellent fragmentation of the stones, ESWL has proven to be an effective and non-invasive
method in the treatment of renal stones.
AIM: The aim of this retrospective study is to evaluate the efficacy and safety of the ESWL as a monotherapy in the
treatment of moderate size kidney stones with stone area (SA) of 100–300 mm².
MATERIALS AND METHODS: We made a retrospective study of 98 patients with moderate size kidney stones with
SA of 100–300 mm², divided into two subgroups, into a group with a SA of 100–200 mm² and with 200–300 mm²,
treated with ESWL in the period of November 2018–December 2019. The patients were treated with a thirdgeneration electromagnetic lithotripter (Lithoskop®, Siemens Medical Systems, Erlangen, Germany), with a source
of electromagnetic shocks (Pulso™) and dual ultrasonographic/fluoroscopic system for detection of the stones. The
stone location, size, maximum energy used, localization technique, number of shock waves, sessions, re-treatment
rate, and additional procedures were reviewed. All the patients before the intervention had a complete laboratory and
radiological examinations. Postoperatively, patients were monitored on the 1st, 30th, and 90th post-operative days.
RESULTS: Ninety-eight patients with solitary kidney stone with a SA of 100–300 mm² were treated with ESWL. The
study included 58 men (59.18%) and 44 women (40.81%). The average length and width of the stone were 15.47
± 2.68 mm and 12.99 ± 2.83 mm, respectively. The average surface area of the stones in our series was 203.78 ±
72.85 mm². The mean number of treatments for the entire series of patients was 1.82 ± 0.91. The mean number of
shock waves for the total series of patients was 3899.11 ± 40. The mean energy used for the overall patient series
was 110106.17 ± 21489.61 mJ. The total re-treatment rate was 47.95%. The entire rate of additional procedures was
19.38%. The overall success rate (SR) in our study was 77.55%. The efficiency quotient for the upper-middle and
lower calyx was 55.57, 57.15, and 30.81, respectively.
CONCLUSION: ESWL is a safe and effective method in the treatment of renal stones, and we recommend as the first
method in the treatment of moderate size kidney stone with a surface area of 100–300 mm². The treatment of each
patient should be individualized and take into account all favored and non-favored factors that influence the decision
to choose extracorporeal lithotripsy as a method of treatment of medium-sized stones.

Item Type:	Article
Impact Factor Value:	0.8
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Ivica Stojanoski
Date Deposited:	20 Feb 2024 13:16
Last Modified:	20 Feb 2024 13:16
URI:	https://eprints.ugd.edu.mk/id/eprint/33672

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