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Progressive increase of lithotripter output produces better in-vivo stone comminution.

Publication ,  Journal Article
Maloney, ME; Marguet, CG; Zhou, Y; Kang, DE; Sung, JC; Springhart, WP; Madden, J; Zhong, P; Preminger, GM
Published in: J Endourol
September 2006

BACKGROUND AND PURPOSE: Shockwave lithotripsy (SWL) has become a first-line intervention for treatment of nephrolithiasis. However, few studies have examined the effects of modifications in the method of shockwave energy administration on comminution efficiency. We propose that a gradual increase in output voltage will produce superior stone fragmentation in comparison with a constant or a decreasing output voltage by optimizing the stress wave and cavitation erosion forces on renal calculi. MATERIALS AND METHODS: BegoStone phantoms were implanted in the renal pelvis of 11 pigs that underwent SWL at a pulse repetition rate of 1 Hz. Animals in the increasing strategy group (N = 4) were subjected to 18, 20, and 22 kV for 600, 600, and 800 shocks, respectively. The second group (N = 4) received a decreasing strategy of 22, 20, and 18 kV for 800, 600, and 600 shocks, respectively. The third group (N = 3) received all 2000 shocks at 20 kV, mimicking the clinical protocol. RESULTS: A progressively decreasing strategy and constant output voltage produced a mean comminution efficiency, or percentage of stone fragments <2 mm, of 89.0% +/- 3.3% and 87.6% +/- 1.7%, respectively. The mean comminution efficiency was improved to 96.5% +/- 1.4% by using the increasing strategy (P = 0.01). CONCLUSIONS: A progressive increase in lithotripter output voltage during SWL can produce greater stone fragmentation than protocols employing constant or decreasing output voltage.

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Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

September 2006

Volume

20

Issue

9

Start / End Page

603 / 606

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Swine
  • Random Allocation
  • Nephrectomy
  • Lithotripsy
  • Kidney Calculi
  • Kidney
  • Female
  • Disease Models, Animal
  • Animals
 

Citation

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Maloney, M. E., Marguet, C. G., Zhou, Y., Kang, D. E., Sung, J. C., Springhart, W. P., … Preminger, G. M. (2006). Progressive increase of lithotripter output produces better in-vivo stone comminution. J Endourol, 20(9), 603–606. https://doi.org/10.1089/end.2006.20.603
Maloney, Michaella E., Charles G. Marguet, Yufeng Zhou, David E. Kang, Jeffery C. Sung, W Patrick Springhart, John Madden, Pei Zhong, and Glenn M. Preminger. “Progressive increase of lithotripter output produces better in-vivo stone comminution.J Endourol 20, no. 9 (September 2006): 603–6. https://doi.org/10.1089/end.2006.20.603.
Maloney ME, Marguet CG, Zhou Y, Kang DE, Sung JC, Springhart WP, et al. Progressive increase of lithotripter output produces better in-vivo stone comminution. J Endourol. 2006 Sep;20(9):603–6.
Maloney, Michaella E., et al. “Progressive increase of lithotripter output produces better in-vivo stone comminution.J Endourol, vol. 20, no. 9, Sept. 2006, pp. 603–06. Pubmed, doi:10.1089/end.2006.20.603.
Maloney ME, Marguet CG, Zhou Y, Kang DE, Sung JC, Springhart WP, Madden J, Zhong P, Preminger GM. Progressive increase of lithotripter output produces better in-vivo stone comminution. J Endourol. 2006 Sep;20(9):603–606.
Journal cover image

Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

September 2006

Volume

20

Issue

9

Start / End Page

603 / 606

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Swine
  • Random Allocation
  • Nephrectomy
  • Lithotripsy
  • Kidney Calculi
  • Kidney
  • Female
  • Disease Models, Animal
  • Animals