Comparing two different ballistic intracorporeal lithotripters in the management of ureteral stones.
BACKGROUND
During the 1990s, two different in situ 'ballistic' lithotripters were introduced into clinical practice. The Swiss Lithoclast (SLC) was the first to be clinically tested. After a few years, a very similar device, the electrokinetic lithotripter (EKL), was described and has recently become available to us. In this paper we compare the clinical efficacy and features of these two ballistic lithotripters in the ureteroscopic treatment of ureteral stones.


METHODS
Thirty-eight patients with ureteral stones were randomized into two equal groups to undergo fragmentation using the SLC or the EKL via semirigid ureteroscope. In both groups the stones were in the mid- or lower ureter. The following parameters were evaluated: total procedure duration, complete fragmentation rate, time to complete fragmentation, proximal migration rate, complications and need for further procedures.


RESULTS
Although not statistically significant, a trend towards a higher fragmentation rate, a shorter time to fragmentation and a slightly higher proximal migration rate emerged in the SLC group. No difference was found in the stone-free rate in the two groups (94.7 vs. 89.4%). Only 2 cases of minor ureteric injury were observed in each group.


CONCLUSIONS
As previously described by others, the SLC and EKL are both attractive cost-effective options in the treatment of ureteral stones. Ten years after its introduction, the SLC still remains probably the best choice for most urologists.
De Sio
Marco
M
Cattedra di Urologia, Azienda Universitaria Policlinico, Seconda Università degli Studi, Napoli, Italy. marcdesio@tin.it
Autorino
Riccardo
R
Damiano
Rocco
R
Oliva
Andrea
A
Perdonà
Sisto
S
D'Armiento
Massimo
M
D000328:Adult; D000368:Aged; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis / Q000628:therapy*; D020709:Ureteroscopes