Piezoelectric Lithotripsy of Renal and Ureteric Stones with the EDAP LT-01

Abstract

One hundred eighty-six patients with upper urinary tract stones underwent piezoelectric lithotripsy (PEL) monotherapy with an EDAP LT-01 lithotripter. All patients were followed up for more than three months after the final session. A total of 560 treatments was performed for 306 renal stones in 141 kidneys and for 84 ureteric stones in 75 ureters. Successful fragmentation was obtained in 75% of renal stone cases and 67% of ureteric stone cases. Successful fragmentation of renal stones was mainly dependent upon the size of the stone. Success was obtained in 93% of stones smaller than 21 mm, in 59% of stones between 21 mm and 30 mm, and in 13% of stones larger than 30 mm in diameter.

One of the problems of the LT-01 lithotripter is the difficulty of localizing ureteric stones with ultrasound visualization. When fragmentation was unsuccessful by in situ PEL, auxiliary retrograde manipulations were required. Successful fragmentation was then obtained in 89% of stones moved into the kidney by these manipulations, but only 31% of those which could not be moved could be fragmented. The success rate of in situ PEL improved to more than 70% after skill was gained in ultrasound visualization. The complications were four subcapsular renal hematomas and 12 ureteric obstructions.

PEL using the EDAP LT-01 is useful for the nonsurgical treatment of urinary tract stones, since this treatment can be performed easily on an outpatient basis without anesthesia.