Comparison of Ultrasonic and Pneumatic Intracorporeal Lithotripsy Techniques during Percutaneous Nephrolithotomy

Abstract

Objectives. To compare the effectiveness and safety of ultrasonic and pneumatic lithotripters in the treatment of renal stone disease. Materials and Methods. A total of 227 consecutive percutaneous nephrolithotomy procedures for renal calculi were performed. In 107 patients ultrasonic lithotriptors were used (group I) and in 83 patients pneumatic lithotriptors were used (group II). In the remaining 37 patients, stones were managed with both pneumatic and ultrasonic lithotripters. Follow-up studies included intravenous urography (IVU) and/or computed tomography (CT). Results. The mean operative time and duration of hospitalization were similar between the groups. In the ultrasonic treatment group, 100 (96.9%) patients were stone-free on postoperative day 1 and 5 (4.6%) went on to undergo an additional treatment modality, resulting in a total stone-free rate of 97.2%. In the pneumatic lithotripsy group, 68 (81.9%) patients were stone-free after the primary procedure on the first day and 15 (18.1%) went on to undergo an additional treatment modality, resulting in a stone-free rate of 91.5%. The final stone-free rates at 3 months postoperatively in groups I, II, and III were 97.2%, 91.5%, and 87.9%, respectively (P = 0.826). Conclusions. We conclude that both ultrasonic and pneumatic lithotripters are effective and safe for intracorporeal lithotripsy. However, the ultrasonic lithotripter provides higher stone-free rates with similar morbidity compared with pneumatic devices.

Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

“…However, there are few studies comparing the combined ultrasound / pneumatic lithotripter to only pneumatic or only ultrasonic lithotripter (6)(7)(8).…”

Clinical application of the therapeutic ultrasound in urologic disease: Part II of therapeutic ultrasound in urology

“…The combination of USL and PL in a lithotripter (dual-probe dual-modality) was expected to perform an additive effect, enhancing the efficacy of stone disintegration. Interestingly, the stone-free rate and safety of these combined lithotripters did not outweigh the USL [ 71 72 73 ]. The quest for a better lithotripter for PCNL continues.…”

Comparative Evaluation Between One Ultrasonic and Two Single-Probe Dual-Energy Lithotripters: In Vitro and In Vivo Experiment in a Porcine Model

“…The development of ultrasonic lithotripters with combined suction led to notable improvements in the stone-free rate, clearance time, and safety for the patients undergoing PCNL. 2,8 Pneumatic lithotripsy was also considered as a highly effective instrument for the fragmentation of all types of stones, but it was associated with longer operative time. This was due to the lack of an integrated suction that dictated the need for the use of retrieval systems for fragment extraction (e.g., grasper).…”