You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal IV1 Apr 20121940 ASSESSMENT OF TISSUE DAMAGE FROM ULTRASONIC, PNEUMATIC, AND COMBINATION LITHOTRIPSY Yuqing Cui, Kevin Mohsenian, Carl Sarkissian, Tianming Gao, and Manoj Monga Yuqing CuiYuqing Cui Minneapolis, MN More articles by this author , Kevin MohsenianKevin Mohsenian Minneapolis, OH More articles by this author , Carl SarkissianCarl Sarkissian Cleveland, OH More articles by this author , Tianming GaoTianming Gao Cleveland, OH More articles by this author , and Manoj MongaManoj Monga Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2098AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To conduct a comparative evaluation of ultrasonic, pneumatic and dual ultrasonic lithotripsy to predict the safety of probes on urinary tract tissue. METHODS Lithotriptors tested were the Swiss Lithoclast Ultra (ultrasonic (US) and ultrasonic-pneumatic combination (US+P)), and the Gyrus ACMI Cyberwand (dual ultrasonic (DUS)). Fresh porcine ureters, bladders, and renal pelvis tissues were used for testing. A hands-free set up was used with each probe and tissue type to vertically apply no pressure (only suction), 400 g, or 700 g of pressure for a duration of 3 seconds, 5 seconds, or 3 minutes (or until perforation of tissue). A total of 117 trials were conducted for each tissue/pressure/time combination for each lithotripsy mode, for a total of 351 trials. Whether tissue perforation occurred, and amount of time prior to perforation was recorded. RESULTS No perforations occurred with 0g pressure. When controlling for tissue type and pressure, the odds of perforation for DUS mode was found to be 5.62 times the odds of perforation for US+P (p=0.0029), and US+P mode was found to have 6.71 times the odds of perforation for US mode (p=0.015). Applying a force of 700g resulted in 45 times the odds of perforation for applying 400g (p<0.0001). Ureter tissue was found to have 83 times the odds of perforation for renal pelvis tissue (p<0.0001), and 2.27 times the odds of perforation for bladder tissue, however, this difference was not significant (p=0.13). A contact duration of 180 seconds resulted in 333.3 and 142.9 times the odds of perforation for contact durations of 3 and 5 seconds, respectively (p<0.0001). CONCLUSIONS Lithotripsy mode, tissue type, pressure, and contact duration were all found to affect the likelihood of tissue perforation. The DUS mode was most likely to perforate tissues, while the US mode was least likely. Renal pelvis tissue was least likely to be perforated, while no significant difference was observed between bladder and ureter tissues with regard to perforation risk. Increased contact time and pressure both significantly and dramatically increased the likelihood of perforation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e783 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yuqing Cui Minneapolis, MN More articles by this author Kevin Mohsenian Minneapolis, OH More articles by this author Carl Sarkissian Cleveland, OH More articles by this author Tianming Gao Cleveland, OH More articles by this author Manoj Monga Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...