title: Efficacy of a mobile lithotripsy service: a one-year review of 222 patients.
abstract: OBJECTIVE
  Extracorporeal shockwave lithotripsy (ESWL) is the management of choice for ureteric and renal stones 20 mm or smaller, with a stone clearance rate of up to 89%. This study determined whether such a high success rate could apply to centres using mobile ESWL, by reviewing the performance at one centre that provides such a service.
  
  
  METHODS
  Between July 2011 and July 2012, 222 patients (median age 51 years, range 18-90 years) underwent one to five sessions of ESWL for ureteric and renal stones (mean size 15 mm, range 4-22 mm). Stone clearance was regarded as residual fragments 2 mm or smaller after completion of sessions.
  
  
  RESULTS
  In total, 110 out of 222 patients (49%) were clear of stones. Stones were radiopaque in 198 (89%) and radiolucent in 24 patients (11%), with clearance rates of 48% and 63%, respectively. Regarding size, 36 (16%) were 1-5 mm, 144 (65%) 5-10 mm, 28 (12%) 10-15 mm, eight (4%) 15-20 mm and six (3%) larger than 20 mm, with clearance rates of 61%, 55%, 18%, 13% and 50%, respectively. In total, 173 (78%) were renal stones and 49 (22%) ureteric, with respective clearance rates of 49% and 51%. For kidney stones, 15 (9%) were in the upper, 32 (18%) in the mid, 75 (43%) in the lower pole and 51 (30%) in the pelvis, with clearance rates of 52%, 59%, 49% and 41%; for ureteric stones, 32 (65%) were in the upper, 10 (20%) in the mid and seven (15%) in the lower ureter, with clearance rates of 47%, 70% and 43%, respectively.
  
  
  CONCLUSIONS
  The performance of mobile ESWL was significantly poorer than expected, and this may be related to a lack of clinical ownership. The authors believe that such a service should be permanently placed on site.
authors: Department of Urology, University Hospitals of Leicester NHS Trust , Leicester , UK.
authors: Shady
authors: S
authors: Nafie
authors: James Edward
authors: JE
authors: Dyer
authors: Jatinder Singh
authors: JS
authors: Minhas
authors: Jonathan Arthur
authors: JA
authors: Mills
authors: Masood Ahmed
authors: MA
authors: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D055815:Young Adult
keywords: ESWL; calculi; lithotripsy; mobile; shockwave; stones