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Treatment philosophy and retreatment rates following piezoelectric lithotripsy.

Publication ,  Journal Article
Fegan, J; Camp, LA; Wilson, WT; Miller, GL; Preminger, GM
Published in: J Urol
January 1993

Second generation lithotriptors offer the advantage of anesthesia-free fragmentation of renal and ureteral calculi but they frequently require multiple treatments to attain a stone-free status. However, excessive single lithotripsy sessions or multiple treatments may be associated with significant damage to the kidney. For some clinicians a common treatment philosophy involves evaluation of serial plain abdominal films every 24 hours after lithotripsy and immediate retreatment of all patients with incomplete fragmentation. To avoid unnecessary retreatments and, thus, minimize potential renal damage, we prospectively evaluated 100 patients undergoing lithotripsy on a Wolf Piezolith 2300 device. Patients were routinely treated with 4,000 shocks at 1,100 bar. Serial plain abdominal films were obtained at 1 day and 2 weeks after lithotripsy. The need for retreatment was determined by the plain abdominal film results. Additional therapy was considered necessary if there was no stone fragmentation or if residual fragments measured greater than 4 mm. Of the patients whose plain abdominal film at 24 hours indicated the need for a repeat treatment 43% were stone-free on the 2-week film. Thus, these patients were spared an unnecessary treatment by allowing adequate time for the stone fragments to pass spontaneously. Our data suggest that repeat treatments on second generation lithotriptors should not be performed within 24 hours. Rather, the patient should be reevaluated at least 1 to 2 weeks later to avoid unnecessary retreatment with the attendant potential for renal injury. In addition, when comparing the retreatment rates of various lithotriptors, one should also consider the treatment philosophy used at the particular institution and the timing of the radiographic studies used to determine the stone-free status.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

January 1993

Volume

149

Issue

1

Start / End Page

12 / 14

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Prospective Studies
  • Lithotripsy
  • Kidney Calculi
  • Humans
  • Electricity
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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ICMJE
MLA
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Fegan, J., Camp, L. A., Wilson, W. T., Miller, G. L., & Preminger, G. M. (1993). Treatment philosophy and retreatment rates following piezoelectric lithotripsy. J Urol, 149(1), 12–14. https://doi.org/10.1016/s0022-5347(17)35984-0
Fegan, J., L. A. Camp, W. T. Wilson, G. L. Miller, and G. M. Preminger. “Treatment philosophy and retreatment rates following piezoelectric lithotripsy.J Urol 149, no. 1 (January 1993): 12–14. https://doi.org/10.1016/s0022-5347(17)35984-0.
Fegan J, Camp LA, Wilson WT, Miller GL, Preminger GM. Treatment philosophy and retreatment rates following piezoelectric lithotripsy. J Urol. 1993 Jan;149(1):12–4.
Fegan, J., et al. “Treatment philosophy and retreatment rates following piezoelectric lithotripsy.J Urol, vol. 149, no. 1, Jan. 1993, pp. 12–14. Pubmed, doi:10.1016/s0022-5347(17)35984-0.
Fegan J, Camp LA, Wilson WT, Miller GL, Preminger GM. Treatment philosophy and retreatment rates following piezoelectric lithotripsy. J Urol. 1993 Jan;149(1):12–14.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

January 1993

Volume

149

Issue

1

Start / End Page

12 / 14

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Prospective Studies
  • Lithotripsy
  • Kidney Calculi
  • Humans
  • Electricity
  • 3202 Clinical sciences
  • 1103 Clinical Sciences