Extracorporeal piezoelectric lithotripsy using the Wolf-lithotriptor versus low energy lithotripsy with the modified Dornier HM-3: a cooperative study

Wolf Piezolith 2200 versus the Modified Dornier HM3

“…visualization of small fragments falling out of the orifice during treatment of an intramural ureter stone or demonstrating moving fragments in the renal pelvis [20], However, particularly in the kidney it is very difficult to differenciate such findings from the effect made by the shock wave itself, i.e. bubbles around the stone due to cavitation [2,9], Sometimes such phenomena mimic the process of fragmentation [19].…”

“…This may lead to a higher number of shock waves hitting their target. On the other hand, cooperative patients can focus the stone by breathing [20], Another important clinical factor is the need of anes thesia. Due mainly to the large aperture of the focussing system, ESWL can be performed without anesthesia with the fact that more double-J stents were placed for the treatment of large calculi with the Dornier HM3+ and more numbers of retrograde mobilizations were neces sary due to the higher percentage of ureteral calculi treated in Stuttgart.…”

“…The range of peak pressure is similar in both systems (table 1). Acoustic coupling is performed by a partial shadow; inhomogenicity and reduction of intensity of the stone reflex, and discrimination of multiple reflex with low intensity [20].…”

“…How ever, only a few of them have proven to be efficacious in clinical trials. These are the Dornier HM4 [8,11], MPL 9000 [22], Sonolith 2000 [14,28] and Medstone 1050 [23], using an underwater electrode; the Siemens Lithostar [26], using an electromagnetic element, and the Wolf Piezolith 2200 [20,27,28] and EDAP LT01 [25], with piezoelectric elements for shock wave generation. Clini cal data have shown that these systems lead to sufficient stone disintegration in at least 80% of the cases.…”

Value of In-Line and Out-of-Line Ultrasound Targeting in Extracorporeal Shock Wave Lithotripsy

“…In a study by Rassweiler et al [ 1 ] only 42% of all urinary stones could be localized by ultra sound and subsequently treated.…”