Assessment of the efficacy of extracorporeal shock wave lithotripsy using a EMSE 140f Dornier Compact Sigma electromagnetic generator, and determination of the effective energy dose
Authors:
Vít Paldus 1; Vladimír Šámal 1,2; Jan Mečl 1; Jiří Pírek 1
Authors‘ workplace:
Urologické oddělení Krajské nemocnice Liberec, a. s.
1; Urologická klinika Fakultní nemocnice a Lékařské fakulty UK, Hradec Králové
2
Published in:
Ces Urol 2014; 18(4): 316-323
Category:
Original article
Overview
Aim:
The aim of this study was to present the initial results of extracorporeal shock wave lithotripsy (ESWL) using a new mobile lithotripter machine – Dornier Compact Sigma, assess its electromagnetic generator efficacy, and determine the mean energy dose applied.
Methods:
Efficacy of ESWL treatment with the use of the new mobile lithotripter machine Dornier Compact Sigma was prospectively assessed in the first 50 patients treated with the device from December 2012 to February 2013. Procedures were performed under analgosedation. Size of the stones was recorded before each procedure. Total energy dose was applied on the basis of the standardized protocol which was determined in advance, using the recommended dose range provided by the manufacturer of the lithotripter. The procedure was prematurely terminated in cases of early stone disintegration visualized using fluoroscopy. Success rate of stone disintegration, stone free rate (SFR), efficacy quotient (EQ) and mean applied energy dose (Edose) were evaluated.
Results:
Native nephrogram and ultrasound were performed three months after the procedure to assess the treatment results. The primary effect of stone disintegration and SFR was achieved in 87.0% and 78.0% of the patients respectively. An auxiliary procedure was subsequently performed in 6 patients. The EQ was determined to be 61.6%, the mean energy dose applied during the LERV procedure was 70.4 J. Subcapsular renal hematoma complication was recorded in one patient.
Conclusion:
Initial results of the LERV procedure in our group demonstrated high efficacy of the EMSE 140f generator with the EQ reaching 61.6%. The mean energy dose (Edose) applied in cases of nephrolithiasis and ureterolithiasis was 73.2 J and 58.0 J respectively. In conclusion, a lower mean effective energy dose proved to be sufficient in our study group when comparing our results to the current data in the lite-rature.
Key words:
extracorporeal shock wave lithotripsy, disintegration, stone free rate, energy dose, efficacy quotient.
Sources
1. Chaussy C, Brendel W, Schmiedt E. Extracorporeally induced destruction of kidney stones by shock wave. Lancet 1980; 2: 165–168.
2. Cleveland RO, McAteer JA. The physics of Shock Wave Lithotripsy. In: Smith AD, Badlani G, Bagley D, Clayman R, other a eds, Smiths Textbook Of Endourology. Hamilton-London: BC Decker Inc 2006; 317–332.
3. Fógel K. Fyzikální základy extrakorporální litotrypse. Ces Urol 2010; 14(2): 73–80.
4. Kerbl K, Rehman J, Landman J, et al. Current management of urolithiasis: progress or regress? J Endourol 2002; 16: 281–288.
5. Granz B, Köhler G. What makes a shock wave efficient in lithotripsy Stones Disease 1992; 4: 123–128.
6. Rassweiler JJ, Bergsdorf T, Ginter S, Granz B, Häcker A, Lutz A, Wess O, Wilbert D. Progress in Lithotripter Technology. In: Chassy C, Haupt G, Jocham D, Köhrmann KU, Wilbert D (eds.) Therapeutic Energy Applications in Urology. Standards and recent developments. Stuttgart – New York: Thieme 2005; 3–15.
7. Rassweiler JJ, Tailly GG, Chaussy C. Progress in lithotriptor technology. EAU Update Series 2005; 17–36.
8. Chaussy C, Tailly G, Forssmann B, Bohris Ch, Lutz A, Tailly-Cusse M, Tailly T. Extracorporeal Shock Wave Lithotripsy in a Nutschell 2013; 3: 13–22.
9. Chaussy C, Haupt G, Jocham D, Köhrmann KU. Consensus: Shock Wave Technology and Application – State of the Art in 2010. Therapeutic Energy Applications in Urology II 2010; 2: 37–52.
10. Denstedt JD, Clayman RV, Preminger GM. Efficacy quotient as a means of comparing lithotripters. J Endourol 1990; 3: 100.
11. Clayman RV, MCLennan BL, Garvin TJ, Denstedt JD, Andriole GL. Lithostar: An electromagnetic acoustic shock wave unit for extracorporeal lithotripsy. J Endourol 1989; 3: 307–313.
12. Rassweiler J, Köhrmann J, Jünemann KP, Alken P. Use of electromagnetic technology. In Smith AD. Controversies in endourology. Philadelphia: WB Saunders Co 1995: 95–106.
13. Graber SF, Danuser H, Hochreiter WW, Studer UE. A prospective randomized trial comparing two lithotriptors for stone disintegration and induced renal trauma. J Urol 2003; 169: 54–57.
14. Sheir KZ, Madbouly K, Elsobky E. Prospective randomized comparative study of the effectiveness and safety of electrohydraulic and electromagnetic extracorporeal shock wave lithotripters. J Urol 2003; 170: 389–392.
15. Ng CF, MacLornan L, Thompson TJ, Tolley D. Comparison of 2 generations of piezoeletric lithotriptors using matched pair analysis. J Urol 2004; 172: 1887–1891.
16. De Marco F, et al. XVIIIth Congress of the European Association of Urology. Madrid, Spain, March 12–15, 2003.
17. Tailly GG. In situ SWL of ureteral stones: comparison between an electrohydraulic and electromagnetic shock wave source. J Endourol 2002; 16: 209–214.
18. Koser M, Rhein A, Haecker M, Rabs U. Extracorporeal shock wave lithotripsy (ESWL) of urinary calculi – effect of shock wave frequency on fragmentation success: preliminary result of prospective study. Eur Urol 2001; 39(Suppl): 58.
19. Sorensen C, Chandhoke P, Moore M, Wolf C, Sarram A. Comparison of intravenous sedation versus general anesthesia on the efficacy of the Doli 50 lithotriptor. J Urol 2002; 168: 35–37.
20. Rassweiler J, Knoll T, Köhrmann K, McAtter J, Lingeman J, Cleveland R, Bailey M, Chaussy Ch. Shock Wave Technology and Application: An Update. Eur Urol 2011; 59(5): 784–796.
21. Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C. Guidelines on urolithiasis 2013. EAU Clinical Guidelines 2013; 5: 19–40.
22. Guanqyan Li, James C. Williams Jr, Yuri A. Pischalnikov, Ziyue Liu, McAteer JA. Size and Location of Defects at the Coupling Interface Affect Lithotripter Performance. BJU Int 2012; 110: E871–E877.
23. Bohris C, Roosen A, Dickmann M, Hocaoglu Y, Sandner S, Bader M, Stief CG, Walther S. Monitoring the coupling of the lithotripter therapy head with skin during routine shock wave lithotripsy with a surveillance camera. J Urol 2012; 187: 157–163.
24. Tailly GG. Optical coupling control in ESWL: first clinical experience. Poster.
25. Pishchalnikov YA, Neucks JS, Von DerHaar RJ, Pishchalnikova IV, Williams Jr JC, McAteer JA. Air pockets trapped during routine coupling in dry head lithotripsy can significantly decrease the delivery of shock wave energy. J Urol 2006; 176: 2706–2710.
26. Petřík A, Záťura F, Beneš J. Vliv stentingu na dezintegraci ureterolitiázy in vitro. Ces Urol 2004; 8(3): 46–48.
27. Petřík A, Alterová E, Fiala M, Novák J, Záťura F. Vliv stentingu na dezintegraci ureterolitázy in vivo. Ces Urol 2006; 10(1): 59–63.
28. Madlouby K, Sheir KZ, Elsobky E, Eraky I, Kenawy M. Risk factors for the formation of steinstrasse after extracorporeal shock wave lithotripsy: a statistical model. J Urol 2002; 167: 12349–12442.
29. Abdel-Khalek M, Sheir KZ, Mokhtar AA, Eraky I, Kenawy M, Bazzed M. Prediction of success rate after extracorporeal shock wave lithotripsy of renal stones – a multivariate analysis model. Scan J Urol Nephrol 2004; 38: 161–167.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2014 Issue 4
Most read in this issue
- Extracoporeal shock wave lithotripsy in current urological practice
- Use of multiparametric magnetic resonance imaging and comparison with other modern imaging methods in the preoperative diagnosis of prostate cancer
- Autonomic dysreflexia in patient after spinal cord injury
- Evaluation of erectile dysfunction after robotic assisted radical prostatectomy