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Electromagnetic DSWL Double Shockwave Lithotripsy : Initial experience. Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina. Urología.
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Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina Urología
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience New design concept for Lithotripters: Double shockwave (1-3). Two independent generators/ reflectors Double shockwave angle of 76 degrees between generators Convergence into a single focal point 1- Sokolov DL, Bailey MR and Crum LA: Dual-pulse lithotripter accelerates stone fragmentation and reduces celllysis in vitro. UltrasoundMedBiol 2003; 29: 1045. 2- Sheir KZ, El-Diasty TA and Ismail AM: Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU Int 2005; 95: 389. 3- Greenstein A, Sofer M and Matzkin H: Efficacy of the Duet lithotripter using two energy sources for stone fragmentation by shockwaves: an in vitro study. J Endourol 2004; 18: 942. Urología
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Double shockwave (4). Butterfly Focal area 4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009. Urología
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Reduce kidney damage Double shockwave Increase treatments efficacy Results? Decreased treatment time 4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009. Urología
Goal Show our initial experience using an extracorporeal double shockwave lithotriptor (Duet Magna, Direx/Initia). Evaluate safety and effectivness . Urología
Method and Materials • Cross-sectional study. • Period March-May 2010. • Patients with renal and uretral stones indicated for ESWL treatment. • Treatments performed with intravenous sedation. • Ambulatory procedure. Urología
Method and Materials Variables Double J catheter. Treatment side. Fragmentation. Complications. Retreats. Removal rate • Age. • Sex. • Weight. • Size. • Body mass index. • Stone sizes and location. Urología
10,0 7,5 5,0 2,5 0,0 30 40 50 60 70 80 Results Patients distribution according to age 33 urinary stones in 30 patients • Average: 53,1 (31 – 76) Urología
Results Patients distribution according to sex (n= 30) Urología
Results Patients distribution according to side treated (n= 33) Urología
Results Patients distribution according to stone localization (n= 33) Urología
Results Patients distribution according to stone size treated (n= 33) Urología
Stone fragmentation: 100 % • Elimination rate: 85% • There were no complications. Urología
Conclusions The double shockwave treatment is a safe and effective procedure. It is necesary to perform additional prospective trials on a larger number of patients in order to confirm the results. Urología