Shockwave lithotripsy: instrumentation and status in China.
OBJECTIVE
To introduce the physical background and technical characteristics of lithotripters made in China and to compare the efficacy of shockwave lithotripsy (SWL) for distal-ureteral stones between Chinese and Western lithotripters in consecutive use in our stone center.


METHODS
From December 1987 to December 2003, we used a series of four lithotripters to treat 1802 patients with distal-ureteral stones: the piezoelectric EDAP LT-01 with ultrasound B-mode scanning for localization (N = 179); the electrohydraulic JDPN-IV lithotripter using fluoroscopy, which is made in China (N = 294), the electromagnetic Dornier Compact S with fluoroscopy/ultrasound dual localization (N = 1105), and the Huikang MZ-SWL-V, which is an electromagnetic- and electrohydraulic-compatible machine with dual localization that is made in China (N = 224). The physical background and technical characteristics of Chinese lithotripters are different from those of Western machines, but the treatment strategies were identical in all series.


RESULTS
In the EDAP LT-01 series, the retreatment rate was 35.2%, and the auxiliary procedure rate was 6.7%, bring the efficiency quotient (EQ) to 69%. In the JDPN-IV series, the retreatment rate was 27.6%, the auxiliary procedure rate 1.0%, and the EQ 74%. In the Dornier Compact S series, the retreatment rate was 12.9%, and auxiliary procedures were performed in 10.9%, for an EQ of 81%. In the Huikang MZ-SWL-V series, the retreatment rate was 20.1%, the auxiliary procedure rate was 4.9%, and the EQ was 80%.


CONCLUSIONS
The fragmentation results of Chinese electrohydraulic and electromagnetic lithotripters are superior to those of the EDAP LT-01. Chinese lithotripters are inferior to the Dornier Compact S in the efficacy of stone fragmentation, but Chinese machines cause less pain than this lithotripter.
Sun
Xi-Zhao
XZ
Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China. sunxizhao@sohu.com
Zhang
Zhi-Wei
ZW
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019233:Retreatment / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014463:Ultrasonography; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000628:therapy*