Comparison of a New-Generation Electroconductive Spark Lithotripter and the Dornier Compact Delta for Ureteral Calculi in a Quaternary Referral Center

Abstract

The Technomed Sonolith Vision is the most recently developed electroconductive lithotripter. Using a case-control study, we compared the treatment outcomes of this machine with those of the Dornier Compact Delta for ureteral calculi. Patients (N = 107) with calculi from the ureteropelvic to the ureterovesical junction undergoing primary lithotripsy using the Technomed Sonolith Vision were identified between September 2004 and February 2005. All patients had 2-week and 3-month follow-up. These patients were compared with 524 patients from our database treated between October 2000 and August 2004 with a Dornier Compact Delta. The two groups were similar at baseline. Outcome variables measured were stone-free rate at 3 months, retreatment rate, and requirement for intravenous analgesia during the procedure. There was a superior stone-free rate for the Technomed, reaching significance for calculi up to 7 mm. The Technomed had a significantly lower re-treatment rate for calculi <13 mm. There was no statistical difference in the requirement for intravenous analgesia. The Efficiency Quotient was superior for the Technomed (0.67 v 0.56). This latest-generation electroconductive lithotripter in its first 6 months of use has shown stone-free and re-treatment rates superior to those of the Dornier Compact Delta and approaching that of the Dornier HM-3. Lithotripsy remains our first-line treatment for all radiopaque ureteral calculi.