Effect of different targeted calyxes on the treatment of multi-site calculi in the postural drainage lithotripsy system.

Objectives: We developed a postural drainage lithotripsy system (PDLS) that can provide an individualized inversion and overturning angle and uses gravity to remove residual fragments (RFs). This study aimed to evaluate the effect of different targeted calyces on treating multi-site stones in PDLS. Methods: A total of 20 stones with different sizes and diameters of 0-4 mm were placed in the kidney model through ureteroscopy, and 20 stones were evenly scattered in the middle calyx and the lower calyx of the model. The ventral-middle calyx, the dorsal-middle calyx, the ventral-lower calyx, and the dorsal-lower calyx were used as the targeted calyx of PDLS to treat multi-site stones. During treatment, if the stone moved from the starting position of the renal calyx to the ureteropelvic junction, it was recorded as "passing through." The clearance rate was recorded, and the efficacy of different targeted calyxes in the treatment of multiple-site calyx was compared. Each model was treated with four different targeted calyxes, and 20 models were tested 80 times. Results: When the lower calyx was the targeted calyx, the total stone clearance rate was higher than when the middle calyx was the locating calyx (94.5 vs. 64%, P = 0.000), and the result was statistically significant. Conclusions: Choosing the lower calyx as the targeted calyx, we can obtain a better stone clearance rate. However, there is no significant difference between the ventral lower calyx and the dorsal lower calyx.

A single center study that evaluates the preclinical use of a newly developed software and moving bed system to facilitate the spontaneous excretion of residual fragments after primary stone treatment (RIRS or PCNL).

PURPOSE: We developed a Postural Drainage Lithotripsy System (PDLS) that uses the patient's computed tomography urography (CTU) data to reconstruct the three-dimensional figure of the renal pelvis, provides an individualized inversion and overturning angle and uses gravity to remove residual fragments (RFs). The purpose of this study was to investigate PDLS in the treatment of renal RFs. METHODS: A stone with a diameter of 4.0 mm was placed in the upper, middle, and lower calyx of the renal model. A total of 60 trials were applied to 20 renal models. The movement trajectory, passage rate, and postural drainage angle of calculi during the treatment of PDLS were observed. RESULTS: All of the stones in 60 trials were observed to move during treatment, and 53/60 (88%) were relocated successfully to the renal pelvis. The passage rate of the upper calyx was 14/20 (70%), that of the middle calyx was 20/20 (100%), and that of the lower calyx was 19/20 (95%). CONCLUSIONS: PDLS can provide individualized inversion and reversal angles and remove stones from the renal model. More clinical trials are needed to verify the above view and evaluate its efficacy.

Innovation of upper urinary tract stone treatment: from passive to active / 中华泌尿外科杂志

Traditional expulsive methods,such as a high fluid intaking,more physical activity and medical expulsive therapy,was aimed at increasing voiding volume,frequency and strength of ureter movement,dilating ureter to detach the stone from mucosa and facilitate the stone clearance.It is usually termed as "passive lithecbole".The external physical vibration lithecbole system has gradually attracted the urologist's attention in recent years.This system develops a simple harmonic to drive the stone explusion along the urinary tract,which was named this new concept as " active lithecbole".The clinic safety and efficacy of active lithecbole has been proved during recent 5 years.In this paper,we reviewed the treatment of upper urinary tract stone from passive lithecbole to active lithecbole,and discussed the innovation of this concept altering.

Innovation of upper urinary tract stone treatment: from passive to active / 中华泌尿外科杂志

Traditional expulsive methods,such as a high fluid intaking,more physical activity and medical expulsive therapy,was aimed at increasing voiding volume,frequency and strength of ureter movement,dilating ureter to detach the stone from mucosa and facilitate the stone clearance.It is usually termed as "passive lithecbole".The external physical vibration lithecbole system has gradually attracted the urologist's attention in recent years.This system develops a simple harmonic to drive the stone explusion along the urinary tract,which was named this new concept as " active lithecbole".The clinic safety and efficacy of active lithecbole has been proved during recent 5 years.In this paper,we reviewed the treatment of upper urinary tract stone from passive lithecbole to active lithecbole,and discussed the innovation of this concept altering.