Reply by authors

Abstract

There is more to clinical results with shock wave lithotripsy than the shock wave instrument alone. Although in vitro experiments have some merit, these studies represent only one aspect of clinical shock wave lithotripsy. Other studies have shown surgeon experience, number of shock waves used, and fluoroscopy time all can impact shock wave lithotripsy success rates. 1 Logarakis N.F. Jewett M.A.S. Luymes J. et al. Variation in clinical outcome following shock wave lithotripsy. J Urol. 2000; 163: 721-725 Crossref PubMed Scopus (92) Google Scholar Our institution is a regional endourology center experienced in percutaneous stone removal and upper tract ureteroscopy, and therefore we elected to treat stones best suited to shock wave lithotripsy. Stone size and location were optimized, which would result in the treatment of smaller (less than 2 cm) renal stones. In addition, all treatments were carried out by the same technologist, well-trained in using the Doli S. Moreover, one group has reported similar clinical success rates to ours in treating renal stones less than 12 mm using the Doli S. 2 Frederick R, Huckabay C, Patel B, et al: Dornier lithotriptor efficacy data. 81st Annual Meeting, South Central Section, American Urological Association, Abstract 58, 2002 Google Scholar Although the Doli S may have improvements over the Doli 50, urologists can also improve their shock wave lithotripsy success rates with careful case selection and an experienced lithotripsy team. This report endeavors to present our results with the Doli S within our practice paradigm, not to compare various lithotriptors.