Mobile lithotripsy service

Published Date: 19th July 2016

Publication Authors: , McCabe JE, , Samsudin A

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Objective

The introduction of Extracorporeal Shockwave lithotripsy (ESWL) in the 1980s revolutionised the treatment of urinary stones. ESWL is a popular treatment option

due to the low risk of morbidity and the reported good rates of stone clearance. Mobile lithotripters offer an ESWL service for DGH populations at a fraction of the cost of a fixed lithotripsy unit. We have audited our mobile lithotripter unit to see if we are attaining stone free rates comparable to the published literature from high volume centres.

Methods

We retrospectively collected data from patients who underwent ESWL (Wolf Piezolith 3000) for the treatment of renal and ureteric calculi over 12 months between 2010 and 2011 at St. Helen's and Knowsley Teaching Hospitals. Two doctors manually measured calculi diameter pre and post treatment using imaging on the PACS system. Primary outcome measures analysed were stone free rate (defined as no visible calculi) and need for operative intervention.

Results

137 consecutive patients were analysed. Mean number of treatment sessions was 2.2 (range 1-8). Mean pre treatment stone size was 7.5mm (range 1-25). Overall stone free rate was 43%. If stone free rate were to be defined as residual calculi < 2mm overall clearance rate equals 51%. 68% of patients were managed with ESWL alone and 32% went on to require operative

intervention.

Conclusions

In our experience, mobile lithotripters are an acceptable alternative to fixed lithotripters and can offer equivalent rates of stone clearance to contemporary published data. This data will help patients make an informed decision when making treatment decisions.

Patrick, NL; Iskander, M; Samsudin, A; Mccabe, J. (2012).  How effective is our mobile lithotripsy service? . Journal of Endourology. 26 (S1), A54-55

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