Faculty Collaboration Database

University of Wisconsin experience using the Doli S lithotriptor. Urology 2003 Sep;62(3):410-4; discussion 414-5

Date

08/30/2003

Pubmed ID

12946735

DOI

10.1016/s0090-4295(03)00555-7

Scopus ID

2-s2.0-0042233895 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

OBJECTIVES: To present our initial results using the Dornier Doli S lithotriptor with the 220 electromagnetic shock wave emitter to treat urinary calculi. At present, there is no published report of the efficacy of this instrument in service in the United States.

METHODS: We retrospectively reviewed the outcome of shock wave lithotripsy in 270 consecutive patients with solitary renal and/or ureteral stones treated from September 1998 to October 2001 with the Dornier Doli S lithotriptor. Data were collected with respect to stone size, location, and fragmentation.

RESULTS: Of the 270 patients treated, 204 had renal stones and 66 had ureteral stones. All patients had solitary stones. The renal stones averaged 9.7 mm in size (range 4 to 26). The ureteral stones averaged 7.8 mm (range 4 to 17). Of the renal stones, 51% were located in the renal pelvis, with 18%, 5%, and 25% located in the upper, middle, and lower poles, respectively. Of the ureteral stones, 68% were located in the proximal ureter, with 14% and 18% in the mid and distal ureter, respectively. In the renal group, 176 (86%) of 204 patients achieved clinical success. Of these patients, 148 were stone free (73%) and 28 had residual fragments less than 4 mm in size (14%). In the ureteral group, 52 (79%) of 66 patients achieved clinical success. Of these patients, 50 were stone free (76%) and 2 (3%) patients had fragments less than 4 mm in size. Thirteen (6%) of 204 patients in the renal group required retreatment. Four (6%) of 62 patients in the ureteral group required retreatment. Of the patients in whom treatment failed and who had stone analysis, 16 (76%) of 21 had stones composed of predominantly calcium oxalate monohydrate. Four patients developed steinstrasse. Two were treated with retrograde stent placement, and the other two with placement of percutaneous nephrostomy. One patient developed a known perinephric hematoma but did not require a blood transfusion.

CONCLUSIONS: Shock wave lithotripsy using the Doli S in appropriately selected patients is an effective instrument for treating urinary calculi throughout the urinary tract.

Author List

Johnson DB, Lowry PS, Schluckebier JA, Kryger JV, Nakada SY

Author

John V. Kryger MD Chief, Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Calcium Oxalate
Follow-Up Studies
Humans
Kidney Calculi
Lithotripsy
Radiographic Image Enhancement
Retrospective Studies
Stents
Treatment Outcome
Ureteral Calculi