Open Access Research article

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision

Kogenta Nakamura1*, Motoi Tobiume1, Masahiro Narushima2, Takahiko Yoshizawa1, Genya Nishikawa1, Yoshiharu Kato1, Remi Katsuda1, Kenji Zennami1, Shigeyuki Aoki1, Yoshiaki Yamada1, Nobuaki Honda1 and Makoto Sumitomo1

Author Affiliations

1 Department of Urology, Aichi Medical University School of Medicine Nagakute, Aichi 480-1195, Japan

2 Department of Urology, Meitetsu Hospital Nagoya, Aichi 451-8511, Japan

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BMC Urology 2011, 11:26  doi:10.1186/1471-2490-11-26

Published: 12 December 2011

Abstract

Background

The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004.

Methods

The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL) alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment.

Results

At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]). Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each.

Conclusions

ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.