Efficacy of a new generation shockwave lithotripsy machine in the treatment of urinary system calculous disease

The aim of this study was to review the treatment results and assess the efficacy and safety of a new generation shock wave lithotripsy machine, Siemens Lithostar Modularis Uro- Plus in 3,024 patients who have been treated with this machine for renal or ureteral stones. In this study, the stone localization, the stone size, maximum and averga energy used, number of shock waves, the localization technique, flouroscopy time, number of ESWL treatment sessions for each stone and post-ESWL secondary treatments were reviewed. The procedure was accepted successful if the patient was stone free or with clinically insignificant residuel fragments for adult patients with renal calculi after 3 months following ESWL treatment. Overall success rate was 85.9%. The success rates for calculi in the renal pelvis, upper calyx, middle calyx, lower calyx, upper ureter, middle ureter and lower ureter were 87.1%, 85.4%, 85.5%, 85.1%, 85.9%, 84.4% and 86.8%, respectively. The mean flouroscopy time was estimated as 5.3 minutes. Major complications were noted as renal subcapsular haematoma in 5 patients, acute pyelonephritis in 2 patients, splenic haematoma in one patient, perirenal urinoma in one patient and acute necrotizing pancreatitis in one patient. Overall efficacy qoutient for this lithotripter according to the methodology of Preminger, Clayman and Denstedt was 0.55. The efficacy quotient of ureteral stones was higher than renal stones. Our experience with Siemens Lithostar Modularis Uro-Plus shows that this third generation lithotripter is safe and effective and provides a 84.4% to 87.1% stone clearance.