Comparative Evaluation of the Results of Contact Pneumatic Cystolithotripsy and Electrohydraulic Cystolithotripsy

Abstract

The objective: to evaluate the performance of portable pneumatic contact lithotripter LMA Stonebreaker (USA) for cystolithotripsy as compared to electrohydraulic cystolithotripsy (Urat-1M).Materials and methods. Contact cystolithotripsy was performed on 63 patients (49 men, 14 women). 27 patients underwent contact pneumatic cystolithotripsy, 36 patients underwent electrohydraulic cystolithotripsy. The effectiveness of the applied methods was evaluated in groups of patients not only by the size of the stones, but also by the mineral composition of the removed stone fragments (uric acid, phosphates, oxalates, ammonium urate). The number of strokes required to initiate fragmentation, complete fragmentation, and total cystolithotripsy time was determined.Results. The stones were fragmented in all 63 (100%) patients, regardless of the method of cystolithotripsy, mineral composition and size, and the stone fragments were completely removed and diagnosed by X-ray structural analysis. The lowest number of strokes to start the fragmentation process was in patients whose stones were diagnosed as ammonium urate and phosphates. Oxalate and uric acid stones required the greatest number of strokes. The number of strokes for complete disintegration of the stone, regardless of the method of cystolithotripsy, depends on the size of the stone, their number, and also the stone’s mineral composition. Conclusion: Transurethral contact pneumatic cystolithotripsy using a portable pneumatic lithotripter LMA Stonebreaker is not inferior to electrohydraulic cystolithotripsy (Urat-1M), however it is safer, taking into account the applied physical effects for stone destruction. It is also less costly.Conclusion. Effectiveness of applying both pneumatic and electrohydraulic cystolithotripsy depends not only on size and quantity of the stones, but also on their mineral composition. There are peculiarities in the process of cystolithotripsy of stones of different mineral composition.