A 2-year Experience with the Wolf Piezoelectric Lithotriptor: Impact of Repeat Treatment On Results and Complications

Abstract

During a 2-year period, 884 extracorporeal piezoelectric lithotripsy treatments have been performed on stones in 388 renal units (kidney and upper ureter) using a Wolf Piezolith device.* Lithotripsy routinely was performed on an outpatient basis without use of anesthesia or premedication. Often, the maximum number of pulses allowable by a Food and Drug Administration protocol (4,000) was delivered and retreatments frequently occurred on successive days. Of the patients 75% were stone-free 3 months after treatment, while another 20% had only residual small fragments. No intrarenal or perinephric hematomas were observed and only 1 patient has had hypertension requiring medication. Renal colic from passage of stone fragments occurred in only 10% of the patients. An aggressive treatment policy using repeat treatments as necessary provides for superior results with this device without an incision or complication.

Extracorporeal Shock Wave Lithotripsy for Lower Caliceal Calculi

“…The second-generation lithotriptors offer significant advances in technology and delivery of shock waves, providing a lower energy density at the entry point combined with improved focusing capacity which afford easier patient handling eliminating treatment in a water bath. As a result, ESWL could be done without anesthesia and complication rates are lower with the second-generation lithotriptors [12, 13]. The Siemens Lithostar Plus, one of the second-generation lithotriptors, is used in our clinic offering the advantages mentioned above.…”