Sound, shock waves shatter kidney stones

Abstract

Surgical treatment of kidney stones is undergoing "very exciting" changes, according to Lynwood H. Smith, MD, professor of medicine at the Mayo Clinic in Rochester, Minn. Speaking at a National Kidney Foundation symposium in Washington, DC, Smith, a nephrologist, summarized recently reported results using two new procedures: percutaneous ultrasonic lithotripsy (PUL) and extracorporeal shock wave lithotripsy (ESWL). Both procedures are used only for stones that otherwise would have to be removed surgically. In PUL, a radiologist, using local anesthesia, first introduces a guide wire percutaneously through the flank into the kidney. The next day, using general anesthesia, dilators are placed over the guide wire. Once dilation is sufficient, a tube resembling a small cystoscope is inserted into the kidney's collecting system and up against the stone. An ultrasoundgenerating instrument developed by European urologists Peter Alkin, MD, and Michael Marberger, MD, is then passed through the tube and used to shatter