title: Comparison of pneumatic, ultrasonic and combination lithotripters in percutaneous nephrolithotripsy.
abstract: OBJECTIVE
  We aimed to compare the outcomes of pneumatic (PL), ultrasonic (UL) and combined (PL/UL) lithotripsy performed in percutaneous lithotripsy (PNL) according to success rates and stone clearence.
  
  
  METHODS
  The medical records of 512 patients treated with PNL between April 2010 and April 2013 were evaluated. Postoperative stone analysis revealed as calcium oxalate in 408 of these patients. The operation notes of 355 patients recorded in detail with complete parameters were reviewed. According to stone disintegration method, patients were divided into three groups: PL only in Group I, UL only in Group II, and UL/PL combination in Group III. Number of patients was 155, 110 and 90, respectively.
  
  
  RESULTS
  Fluoroscopy screening time was significantly shorter in group II, and III compared to group I (p<0.001). The failure rates were 13.5% (21 patients) for group I, 3.6% (4 patients) for group II, and 3.3% (3 patients) for group III. There was a significant statistical difference in favor of group II and III by means of success (p=0.023). Group II and III had larger FSA, and this was statistically significant (p=0.032). Stone disintegration time (SDT) was 64.0 ± 41.92 minutes for group I, 49.5 ± 34.63 for group II, and 37.7 ± 16.89 for group III. Group III has a statistically significant shorter SDT (p=0.011).
  
  
  CONCLUSIONS
  We concluded that, in cases with high stone burden, where faster and efficient lithotripsy is needed, combined ultrasonic / pneumatic lithotripter may be the ideal choice and in suitable cases ultrasonic lithotripter usage provides important advantages to the surgeon.
authors.affiliation: Department of Urology, Bozok University, Faculty of Medicine, Yozgat, Turkey.
authors.forename: Kursad
authors.initials: K
authors.lastname: Zengin
authors.affiliation: Department of Urology, Numune Education and Research Hospital, Adana, Turkey.
authors.forename: Nevzat Can
authors.initials: NC
authors.lastname: Sener
authors.affiliation: Department of Urology, Abdurrahman Yurtaslan Education and Research Hospital, Ankara, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Bas
authors.affiliation: Department of Urology, Yenimahalle State Hospital, Ankara, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Nalbant
authors.affiliation: Department of Urology, Fethiye State Hospital, Mugla, Turkey.
authors.forename: Inan
authors.initials: I
authors.lastname: Alisir
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003131:Combined Modality Therapy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D007902:Length of Stay; D008096:Lithotripsy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D061646:Operative Time; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome