Extracorporeal shock wave lithotripsy: the use of chemical treatments for improved stone comminution.
Journal Article (Journal Article)
Extracorporeal shock wave lithotripsy (ESWL) can require more than two thousand acoustic shocks to achieve an adequate degree of renal calculus comminution. A decrease in the number of shocks necessary for effective treatment offers both technical and clinical benefits. The results presented here demonstrate that it is possible in particular cases to increase substantially the degree of comminution produced using a fixed number of acoustic impulses by exposing the stones to solutions of controlled pH and chemical composition during acoustic shock treatment. The largest increase in comminution was observed for magnesium ammonium phosphate hexahydrate/apatite stones exposed to citrate solutions. The smaller particle sizes are shown to result not only from stone dissolution but also from an increase in the ease of stone fracture during acoustic shocking. The degree of comminution of the largest fragment sizes was also found to be slightly increased for calcium oxalate stones by exposure to synthetic urine of elevated pH. These chemical methods of increased stone comminution appear to be directly applicable to particular cases and may have general clinical utility if suitable conditions affecting all stones can be found.
Full Text
Duke Authors
Cited Authors
- Akers, SR; Cocks, FH; Weinerth, JL
Published Date
- November 1987
Published In
Volume / Issue
- 138 / 5
Start / End Page
- 1295 - 1300
PubMed ID
- 3669190
International Standard Serial Number (ISSN)
- 0022-5347
Digital Object Identifier (DOI)
- 10.1016/s0022-5347(17)43587-7
Language
- eng
Conference Location
- United States