title: Lithotripter outcomes in a community practice setting: comparison of an electromagnetic and an electrohydraulic lithotripter.
abstract: OBJECTIVE
  We assessed patient outcomes using 2 widely different contemporary lithotripters.
  
  
  METHODS
  We performed a consecutive case series study of 355 patients in a large private practice group using a Modulith® SLX electromagnetic lithotripter in 200 patients and a LithoGold LG-380 electrohydraulic lithotripter (TRT, Woodstock, Georgia) in 155. Patients were followed at approximately 2 weeks. All preoperative and postoperative films were reviewed blindly by a dedicated genitourinary radiologist. The stone-free rate was defined as no residual fragments remaining after a single session of shock wave lithotripsy without an ancillary procedure.
  
  
  RESULTS
  Patients with multiple stones were excluded from analysis, leaving 76 and 142 treated with electrohydraulic and electromagnetic lithotripsy, respectively. The stone-free rate was similar for the electrohydraulic and electromagnetic lithotripters (29 of 76 patients or 38.2% and 69 of 142 or 48.6%, p = 0.15) with no difference in the stone-free outcome for renal stones (20 of 45 or 44.4% and 33 of 66 or 50%, p = 0.70) or ureteral stones (9 of 31 or 29% and 36 of 76 or 47.4%, respectively, p = 0.08). The percent of stones that did not break was similar for the electrohydraulic and electromagnetic devices (10 of 76 patients or 13.2% and 23 of 142 or 16.2%) and ureteroscopy was the most common ancillary procedure (18 of 22 or 81.8% and 30 of 40 or 75%, respectively). The overall mean number of procedures performed in patients in the 2 groups was similar (1.7 and 1.5, respectively).
  
  
  CONCLUSIONS
  We present lithotripsy outcomes in the setting of a suburban urology practice. Stone-free rates were modest using shock wave lithotripsy alone but access to ureteroscopy provided satisfactory outcomes overall. Although the acoustic characteristics of the electrohydraulic and electromagnetic lithotripters differ substantially, outcomes with these 2 machines were similar.
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Naeem
authors.initials: N
authors.lastname: Bhojani
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Mandeville
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Tariq A
authors.initials: TA
authors.lastname: Hameed
authors.affiliation: First Urology, Jeffersonville, Indiana.
authors.forename: Trevor M
authors.initials: TM
authors.lastname: Soergel
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: James A
authors.initials: JA
authors.lastname: McAteer
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: James C
authors.initials: JC
authors.lastname: Williams
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Krambeck
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: jlingeman@iuhealth.org.
authors.forename: James E
authors.initials: JE
authors.lastname: Lingeman
mesh_terms: D003151:Community Health Centers; D055590:Electromagnetic Phenomena; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*
keywords: equipment and supplies; kidney calculi; lithotripsy; treatment outcome; ureteral calculi