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Piezoelectric Lithotripsy Monotherapy (EDAP LT-01) for Partial or Total Staghorn Stones and Large Non-Staghorn Renal Calculi

  • J. A. Amiel
  • A. Y. Peyrottes
  • K. Touabi
  • E. J. Benizri
  • J. Toubol

Abstract

Thirty patients with partial or total staghorn stones or calculi larger than 30 mm were treated by piezoelectric lithotripsy (PEL) monotherapy using an EDAP LT-01 lithotripter with ultrasound guidance. Nineteen of these patients had pelvic stones; the other 11 had partial (9) or total (2) staghorn stones. All patients first underwent an initial lithotripsy session. No anesthesia or IV sedation was required in any case. If stone fracturization was achieved during this first session, a double-J stent was inserted before the second lithotripsy session. Prior to the first session, 18 of 30 patients had sterile urine cultures; 12 of 30 presented major distention of the excretory tract.

Results were analyzed to determine the factors influencing the outcome of this therapy. Three months after the first session, patients were considered cured if their stones had completely disappeared according to plain abdominal films (14 of 30, 46%). In seven patients (23.3%), fracturization had occurred but residual fragments remained (1 to 3 fragments ≤ 4 mm). No fracturization was obtained after the first session in nine patients (30.7%) (1 total staghorn stone, 8 pelvic stones). The mean number of treatment sessions was five (range, 1 to 15). Complications occurred in only 10% of patients (3 of 30): two steinstrassen and one acute pyelonephritis. Eighty-three percent of patients without major excretory tract distention and 55% of patients whose initial urine culture was sterile achieved a stone-free state. Therefore, the best indications for PEL monotherapy for calculi larger than 30 mm are pelvic stones and partial staghorn stones and no major excretory tract dilatation in patients with sterile initial urine cultures. Insertion of a double-J stent considerably reduces the incidence of post-PEL complications. With 46% of patients stone free three months after PEL monotherapy, this treatment can be considered effective. The fact that no anesthesia is required for PEL with the EDAP LT-01 makes this technique an interesting alternative to combined therapy.

Keywords

Shock Wave Lithotripsy Extracorporeal Shock Wave Lithotripsy Acute Pyelonephritis Residual Fragment Average Surface Area 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Neerhut GJ, et al: PEL monotherapy for staghorn stones: indications and limitations. Presented at VIth World Congress on Endourology and ESWL, Paris, France, September 13, 1988.Google Scholar
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    Van den Bossche M, et al: ESWL of staghorn calculi with the Lithostar. Presented at VIth World Congress on Endourology and ESWL, Paris, France, September 1–3, 1988.Google Scholar
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    Van der Versen R, et al: ESWL monotherapy for staghorn calculi: Lithostar. Presented at VIth World Congress on Endourology and ESWL, Paris, France, September 1–3, 1988.Google Scholar
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    de Geeter P, et al: ESWL monotherapy for large renal stones ( 300 mm2). Presented at VIth World Congress on Endourology and ESWL, Paris, France, September 1–3, 1988.Google Scholar
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    Gleeson MJ, et al: ESWL monotherapy for large (3 cm) renal calculi. Presented at VIth World Congress on Endourology and ESWL, Paris, France, September 1–3, 1988.Google Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • J. A. Amiel
    • 1
  • A. Y. Peyrottes
    • 1
  • K. Touabi
    • 1
  • E. J. Benizri
    • 1
  • J. Toubol
    • 1
  1. 1.Service d’Urologie, Centre Hospitalier Regional et Universitaire de NiceHopital PasteurNice CedexFrance

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