title: Clinical experience with shock-wave lithotripsy using the Siemens Modularis Vario lithotripter.
abstract: OBJECTIVE
  To assess the effectiveness of a lithotripter (Modularis Vario; Siemens, AG Healthcare, Munich, Germany) in the management of renal and ureteric stones.
  
  
  METHODS
  In all, 1146 adult patients with renal or ureteric stones were treated at one urological centre using the latest model of the Modularis Vario lithotripter. The effectiveness of lithotripsy and re-treatment rate were assessed. Data were obtained on stone location, stone size, shock wave usage, success rate, and complications.
  
  
  RESULTS
  Between May 2007 and November 2009, 698 patients with renal stones and 448 with ureteric stones underwent extracorporeal shock-wave lithotripsy (ESWL). The mean (SD) renal stone size was 12.8 (3.8) mm; a mean of 1.36 sessions was required, with a mean (SD) number of 3744 (1961) shocks delivered per renal stone. After 3 months, the success rate defined as the patient being stone-free or with residual fragments of <4 mm; for renal stones the rate was 91.1%, with a 6.9% complication rate in the form of steinstrasse and severe renal colic. The mean (SD) ureteric stone size was 10.4 (2.7) mm. A mean of 1.37 sessions was required, with a mean (SD) of 4551 (2467) shocks delivered for each ureteric stone. The success rate for ureteric stones was 89.5%, with a 5.6% complication rate. The overall efficiency quotient was 0.66.
  
  
  CONCLUSIONS
  The Siemens Modularis Vario lithotripter is a safe and effective machine for treating renal and ureteric stones.
authors.affiliation: Department of Urology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Hassouna
authors.affiliation: Department of Urology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Samir
authors.initials: S
authors.lastname: Oraby
authors.affiliation: Department of Urology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: Sameh
authors.affiliation: Department of Urology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Abbady
keywords: EQ, effectiveness quotient; KUB, plain abdominal film of the kidney, ureter, and bladder; Kidney; Shock-wave lithotripsy; Stones; Ureter