Clinical experience of extracorporeal shock wave lithotripsy(Dornier lithotriptor MPL 9000) for urinary calculi / 대한비뇨기과학회지

MPL 9000 lithotriptor may be characterized by ultrasonic localization, automatic target system, water cushion and under water spark gap generation of shock wave. In an effort to evaluate clinical efficiency of this machine, we analyzed therapeutic results of 250 cases of urinary calculi treated by extracorporeal shock wave lithotripsy (ESWL) using MPL 9000 lithotriptor. Technically it was difficult to visualize the upper ureter stones with ultrasonic scanning, so all of them were pushed up before treatment. For staghorn stones or large stones, percutaneous nephrolithotomy (PCNL) or ureteral stenting were performed before treatment selectively. The overall stone free rate. at 4 weeks after last session, was 89.2% while that of stones larger than 3cm was 50%. The complications such as gross hematuria, flank pain, steinstrasse and fever were controlled successfully by conservative treatment. In conclusion, ESWL with MPL 9000 might be successful in most patients with urolithiasis but in cases of large renal stone or upper ureteral stone auxiliary procedures will be required.

Initial Clinical Trials of Urinary Stones with Dornier Lithotriptor MPL 9000 / 대한비뇨기과학회지

Extracorporeal shock wave lithotripsy was performed in 231 patients for 13 months with Dornier MPL 9000 lithotriptor. The 231 patients had renal ( 48.9%) or ureteral (51.1%) stones varying from 0.6 to 4.4cm (mean 1.2cm) in size. Among 231 patients, 184 patients (79.7%) completed the treatment with 1 session and the number of treatment sessions increased in larger stones and in situ impacted ureteral stones, with an average of 1.3 sessions. The success rate (rate free of calculi plus that of clinically insignificant residual fragments) was 98.3 %. No general or regional anesthesia was required but parental analgesics were required in 22.9% of the treatment sessions. There were no significant complications in any patient. Therefore, extracorporeal shock wave lithotripsy with Dornier MPL 9000 lithotriptor is considered to be a safe and efficient procedure for initial treatment of urinary stones.