The Outcomes and Complications of A Third Generation Shockwave Lithotripter.

Introduction & Objectives: To evaluate the treatment outcomes and complication rates of third generation (Lithoskop®) lithotripters in patients with urolithiasis who underwent shockwave lithotripsy (SWL).

Materials & Methods: A total of 840 consecutive patients who underwent SWL with Lithoskop in our department were retrospectively analyzed. Outcomes were analyzed by plain abdominal film of kidney, ureter and bladder and renal ultrasonography for radiopaque and computerized tomography for radiolucent stones 1 day after treatment and after 1 month. Patients were grouped into two according to the results; as stone free and residual stone. Clinically insignificant residual fragments were considered as residual stone. The outcomes and complication rates are given.

Results: The mean (range) patient age was 48. 6 (1-85) years, including 64 children, and 67. 7% of the patients were male. In all, 61. 8% of the calculi were localized in the kidney, 37. 0% in the ureter and 1. 2% multiple. Renal stones were localized in the upper, middle and lower calyx and in the renal pelvis in 14, 12, 39 and 35% of patients, respectively. Ureteric stones were localized in the upper, mid- and distal ureter in 62, 10 and

28% of patients, respectively. The mean stone burden was 0-1 cm2 in 71. 9%, 1. 1-2 cm2 in 23. 9% and > 2 cm2 in 4. 1%. The overall stone-free rate after was 69. 3%; the mean number of sessions to achieve these rates was 2. 69. There was no major complication. The rate of Steinstrasse was 2. 1%.

Conclusions: Third generation lithotripter was found successful for the treatment of urolithiasis with SWL, in this retrospective study. The rate of Steinstrasse was low. Prospective randomized studies comparing with standard lithotripter are needed.