Efficacy and Safety of a New Generation Shockwave Lithotripsy Machine in the Treatment of Single Renal or Ureteral Stones Experience with 2670 Patients

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PURPOSE: To review the treatment efficacy and to assess the complications encountered in patients with single renal or ureteral calculi managed with a new-generation SWL machine, the Siemens Lithostar Modularis Uro-Plus. PATIENTS AND METHODS: The stone location, size, minimum and maximum energy used, localization technique, number of shockwaves, fluoroscopy time, and number of sessions were reviewed for 2670 patients. The medical records were consulted to identify post-SWL secondary treatments in order to calculate the efficacy quotient (EQ). RESULTS: The stone-free rate was 79%. Calculi in the renal pelvis and upper, middle, and lower ureter had success rates of 86%, 86%, 86%, and 85%, respectively (P < 0.05). Higher re-treatment rates were encountered for midureteral stones (P < 0.05). The major complications were renal hematoma, acute pyelonephritis, perirenal abscess, and acute pancreatitis. The overall EQ was 0.67. The EQ was higher for the renal pelvis (0.73) and upper ureter (0.71). CONCLUSION: Our experience has shown that this new lithotripter is safe and provides a 68% to 86% chance of stone clearance.