Shockwave Lithotripsy: Instrumentation and Status in China

Abstract

To introduce the physical background and technical characteristics of lithotripters made in China and to compare the efficacy of shockwave lithotripsy (SWL) for distal-ureteral stones between Chinese and Western lithotripters in consecutive use in our stone center. From December 1987 to December 2003, we used a series of four lithotripters to treat 1802 patients with distal-ureteral stones: the piezoelectric EDAP LT-01 with ultrasound B-mode scanning for localization (N = 179); the electrohydraulic JDPN-IV lithotripter using fluoroscopy, which is made in China (N = 294), the electromagnetic Dornier Compact S with fluoroscopy/ultrasound dual localization (N = 1105), and the Huikang MZ-SWL-V, which is an electromagnetic- and electrohydraulic-compatible machine with dual localization that is made in China (N = 224). The physical background and technical characteristics of Chinese lithotripters are different from those of Western machines, but the treatment strategies were identical in all series. In the EDAP LT-01 series, the retreatment rate was 35.2%, and the auxiliary procedure rate was 6.7%, bring the efficiency quotient (EQ) to 69%. In the JDPN-IV series, the retreatment rate was 27.6%, the auxiliary procedure rate 1.0%, and the EQ 74%. In the Dornier Compact S series, the retreatment rate was 12.9%, and auxiliary procedures were performed in 10.9%, for an EQ of 81%. In the Huikang MZ-SWL-V series, the retreatment rate was 20.1%, the auxiliary procedure rate was 4.9%, and the EQ was 80%. The fragmentation results of Chinese electrohydraulic and electromagnetic lithotripters are superior to those of the EDAP LT-01. Chinese lithotripters are inferior to the Dornier Compact S in the efficacy of stone fragmentation, but Chinese machines cause less pain than this lithotripter.