Suboptimal treatment results with the Therasonics lithotriptor.
From July 1988 to August 1991, 174 stone treatments were attempted on 112 stones in 86 patients using a Therasonics lithotriptor. Mean stone diameter was 13 mm. (range 4 to 60). The success rate (defined as no debris or fragments less than 4 mm. in an asymptomatic patient) was 49% and the retreatment rate was 63%. Subjects reported moderate to severe pain during 70 treatment sessions (42%) despite sedation with parenteral narcotics (50 to 100 mg. meperidine and 50 mg. hydroxyzine intramuscularly). One patient had perirenal bleeding requiring a 7-unit blood transfusion. Of the treatments 24 (13%) were aborted, 10 due to pain and 13 because of inability of the operator to position the patient or localize the stone. These results appear to be inferior to those reported with alternative lithotriptors. Modifications that have been made in the Therasonics system may improve stone localization and treatment results.
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765.
J B
JB
Robertson
M O
MO
Koch
F K
FK
Kirchner
J A
JA
Smith
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000295:instrumentation*; D008875:Middle Aged; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*