Document Detail


Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study.
MedLine Citation:
PMID:  15679800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To present the results of the first clinical study of a synchronous twin-pulse technique for extracorporeal shock-wave lithotripsy (ESWL), which is effective for in vitro stone fragmentation and safe when assessed in vivo on animal tissue. PATIENTS AND METHODS: Fifty patients with urinary stones (35 men and 15 women) were enrolled and treated with the TWINHEADS lithotripter. The entry criteria were: age > or = 18 years, with a radio-opaque single stone in the kidney or upper ureter, a normal laboratory profile (serum creatinine, liver function, blood, bleeding and clotting times, and prothrombin concentration). The exclusion criteria included lower ureteric stones, patients with urinary tract infection, obstructed urinary tract distal to the stones, or congenital abnormalities. All patients received one session and were evaluated by ultrasonography (US), urinary tract plain X-ray, and complete laboratory investigations before and immediately after treatment, and after 2, 14 and 30 days. Patients requiring re-treatment at the 14-day visit received a second session and were re-evaluated after 7 and 14 days. RESULTS: The mean (sd, range) stone size (longest diameter) was 12.3 (2.6, 9-18) mm. Intravenous sedation was used in 30 patients. There was mild haematuria in 25 patients on the day of treatment. During the follow-up there was no evidence of haematoma, gross renal injury, upper urinary tract obstruction or significant changes in the laboratory investigations. After 14 days, 17 patients (34%) were free of stones, with residual stones of < or = 5 mm in 20 (40%); they were free of stones at the 1-month follow-up. Thirteen patients (26%) had residual stones of 6-9 mm, but the stones were half or less of the original size. Patients with residual stones of > 5 mm had another ESWL session and were free of stones within 14 days. Thus all patients were rendered stone-free within 1 month. CONCLUSIONS: Synchronous twin-pulse ESWL is promising, seems safe and effective for treating patients with renal and upper ureteric lithiasis.
Authors:
Khaled Z Sheir; Tarek A El-Diasty; Amani M Ismail
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  BJU international     Volume:  95     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2005-03-21     Revised Date:  2006-07-18    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  389-93     Citation Subset:  IM    
Affiliation:
Department of Urology, Mansoura University, Elgomhoria St., 35516, Mansoura, Egypt. kzsheir@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Colic / etiology
Equipment Design
Female
Hematuria / etiology
Humans
Kidney Calculi / chemistry,  therapy*
Lithotripsy / instrumentation,  methods*
Male
Middle Aged
Prospective Studies
Retreatment
Treatment Outcome
Ureteral Calculi / chemistry,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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