Extracorporeal Shock Wave Lithotripsy with the Lithostar Lithotriptor

Early experience of extracorporeal shock wave lithotripsy (ESWL) using the Lithostar lithotriptor is reported; 145 patients underwent 185 treatments for 189 stones. Treatments were performed with either intravenous sedation and analgesia (90%) or general anaesthesia (10%). There were 123 renal calculi, 44 ureteric calculi and 22 staghorn calculi. Stone fragmentation was achieved with 1724 +/- 1035 shocks at 19 kv. The immediate stone fragmentation rate was 90% and the 3-month clearance rate 88%. Secondary treatments were required in 19% of patients and additional procedures in 17%. A comparison between stone size and the number of shock waves required to achieve stone fragmentation revealed a linear relationship. The Lithostar is a very effective second generation lithotriptor which can be used for renal, staghorn and ureteric calculi in situ, without manipulation.