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The effect of focus size and intensity on stone fragmentation in SWL on a piezoelectric lithotripter.

Abstract：

PURPOSE:We aim to analyze the efficacy of different focus sizes and the influence of pulse pressure (intensity) during shock wave lithotripsy (SWL) in terms of stone fragmentation. METHODS:Combination of three focal sizes (F1 = 2 mm, F2 = 4 mm, F3 = 8 mm) and 11 output pressure settings (intensity 10-20) of a piezoelectric lithotripter (Wolf PiezoLith 3000) were tested on artificial stones (n = 99). The stones were placed within a 2 mm mesh cage. The needed number of shockwaves (SW) to first visible crack, 50% and 100% stone disintegration were recorded. RESULTS:Similar number of SW's were observed until the first crack 10, 11 and 11 SW's for F1, F2, and F3, respectively (p > 0,05). The median number of SW needed for 50% stone disintegration was 245 for F1 group, 242 for F2 group and 656 for F3 group. F1 vs F2 p = 0.7, F1 vs F3 and F2 vs F3 p < 0.05. Similarly, with larger focus size a higher number of shockwaves were necessary for 100% stone disintegration. 894, 877 and 1708 SW's for F1, F2 and F3, respectively. Only for F1 vs F3 and F2 vs F3 (all p < 0.05) a statistical difference was observed. These findings were consistent in all different power settings, with an increased difference in lower power levels (≤ 14). CONCLUSIONS:A smaller focus size, as well as a higher peak pressure results in a more effective stone fragmentation. However, these results need to be confirmed in an in vivo setting with multiple parameters interfering the efficacy, like BMI, respiration or stone migration.

journal_name

World J Urol

journal_title

World journal of urology

authors

Veser J,Jahrreiss V,Seitz C,Özsoy M

doi

10.1007/s00345-019-03069-y

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

2645-2650

issue

10

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-019-03069-y

journal_volume

38

pub_type

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