Efficacy and safety of the Healthtronics LithoTron lithotripter.
OBJECTIVE
To evaluate our experience with the LithoTron lithotripter (Healthtronics, Atlanta, GA), a dry portable system that utilizes a spark-gap electrode as an energy source.


METHODS
We prospectively evaluated the first 312 treatments performed on 199 men and 99 women with an average age of 43.5 years (range 4 months-80 years), over a 25-month period between May 1999 and June 2001. Of the 468 stones treated, 136 were located in the ureter, 52 in the renal pelvis or ureteropelvic junction, and 230 in the kidney; the sites of 50 were not specified in our database. The average stone size was 8.0 mm (range 1-40 mm). Follow-up included a plain (KUB) film, CT scan, or intravenous urogram (IVU) and was available for 256 patients. "Stone free" was defined as no fragments visible on postoperative images. The mean radiographic follow-up was 74 days (range 0-866 days). Data collection was initially done manually by data sheets, but a Web-based medical database application was developed in order to enter, store, retrieve, and analyze the data more efficiently.


RESULTS
The average number of shocks delivered per renal unit was 2689 at 25.8 kV. Seventy-five percent of the procedures were performed with intravenous sedation. Two thirds (169/256) of the patients were rendered stone free with one treatment. According to size, 71% (209/294) of stones <1 cm, 57% (39/68) of stones between 1.0 and 1.5 cm, and 22% (8/36) of stones >1.5 cm were eliminated. There were 23 patients who required further treatment; from the available data, 18 of them are currently stone free. Perioperative complications occurred in 6 patients (2%). No patient had worsening renal function or new-onset hypertension. The effectiveness quotient was 59.3%.


CONCLUSIONS
The LithoTron lithotripter is satisfactory for stones <1 cm.
Department of Urology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Pankaj M
PM
Jain
Nazli
N
Goharian
Adam C
AC
Weiser
Herbert M
HM
User
Simon
S
Kimm
Samuel C
SC
Kim
Jeffrey A
JA
Stern
Joseph
J
Pazona
Christopher
C
Wambi
Ronald
R
Yap
Lynn W
LW
Blunt
Robert B
RB
Nadler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004566:Electrodes; D005260:Female; D006801:Humans; D007223:Infant; D008096:Lithotripsy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000000981:diagnostic imaging / Q000628:therapy; D014567:Urography