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Impact of official technical training for urologists on the efficacy of shock wave lithotripsy

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Abstract

To evaluate the efficacy of company-initiated training of urologists on shock wave lithotripsy (SWL) treatment results, we retrospectively assessed 602 patients who underwent SWL in Nagoya City University Hospital between January 2004 and June 2011 using Lithotripter S (Dornier MedTech, Japan). Training—provided by a training specialist of the company in June 2010—focused on the targeting of renal and proximal ureter stones with a combination of radiography and ultrasonography (US). The stretcher wedges were positioned in the semi-prone position or the semi-supine position for middle and distal ureter stones, respectively. Success rates between 519 pre-training treatments and 83 post-training treatments were compared. Patient age and stone location, burden, number, and composition did not significantly differ between pre- and post-training. Training improved the overall success rate from 66.3 to 87.2 % (P < 0.0001). The mean number of SWL treatments decreased from 1.8 ± 1.8 to 1.4 ± 1.3 (P = 0.01). The first SWL treatment success rate increased from 67.1 to 83.7 % (P = 0.002), and the need for multiple treatments decreased. The frequency of detection of renal and proximal ureter stones by both radiography and US increased from 10.5 % before training to 58.2 % after training (P < 0.0001). Significant factors for successful SWL were determined to be training and prone position for distal ureter stones by multivariate analysis and ultrasonic detection for renal and proximal ureter stones by univariate analysis. Skills in targeting stones using ultrasonography and selecting the proper therapeutic position are essential for improving the success rate of stone removal.

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Acknowledgments

We would like to thank Dornier MedTech, Japan, for the technical training they provided.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan

    Atsushi Okada, Takahiro Yasui, Kazumi Taguchi, Kazuhiro Niimi, Yasuhiko Hirose, Shuzo Hamamoto, Ryosuke Ando, Yasue Kubota, Yukihiro Umemoto, Keiichi Tozawa, Shoichi Sasaki, Yutaro Hayashi & Kenjiro Kohri

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  1. Atsushi Okada
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  2. Takahiro Yasui
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  3. Kazumi Taguchi
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  4. Kazuhiro Niimi
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  5. Yasuhiko Hirose
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  6. Shuzo Hamamoto
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  7. Ryosuke Ando
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  8. Yasue Kubota
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  9. Yukihiro Umemoto
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  10. Keiichi Tozawa
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  11. Shoichi Sasaki
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  12. Yutaro Hayashi
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  13. Kenjiro Kohri
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Corresponding author

Correspondence to Takahiro Yasui.

Electronic supplementary material

Below is the link to the electronic supplementary material.

240_2013_586_MOESM1_ESM.pdf

Figure 1 Checklist for the shock wave lithotripsy technical training course. This checklist was used during the SWL training that was initiated on June 4, 2010, and performed by the customer support service department of Dornier MedTech Japan (PDF 61 kb)

240_2013_586_MOESM2_ESM.pdf

Figure 2 Training sheet describing basic techniques for body positioning in SWL. This training sheet was used to indicate the basic techniques for body positioning in SWL (PDF 7467 kb)

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Okada, A., Yasui, T., Taguchi, K. et al. Impact of official technical training for urologists on the efficacy of shock wave lithotripsy. Urolithiasis 41, 487–492 (2013). https://doi.org/10.1007/s00240-013-0586-3

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  • DOI: https://doi.org/10.1007/s00240-013-0586-3

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