Electromagnetic DSWL Double Shockwave Lithotripsy Initial experience Dr

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina Urología

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience New design concept for Lithotripters: Double shockwave (1 -3). Two independent generators/ reflectors Double shockwave angle of 76 degrees between generators Convergence into a single focal point 1 - Sokolov DL, Bailey MR and Crum LA: Dual-pulse lithotripter accelerates stone fragmentation and reduces cell lysis in vitro. Ultrasound Med Biol 2003; 29: 1045. 2 - Sheir KZ, El-Diasty TA and Ismail AM: Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU Int 2005; 95: 389. 3 - Greenstein A, Sofer M and Matzkin H: Efficacy of the Duet lithotripter using two energy sources for stone fragmentation by shockwaves: an in vitro study. J Endourol 2004; 18: 942. Urología

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Double shockwave (4). Butterfly Focal area 4 - Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884 -889, February 2009. Urología

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience Reduce kidney damage Double shockwave Increase treatments efficacy Decreased treatment time Results? 4 - Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884 -889, February 2009. Urología

Goal • Show our initial experience using an extracorporeal double shockwave lithotriptor (Duet Magna, Direx/Initia). • Evaluate safety and effectivness. Urología

Method and Materials Ø Cross-sectional study. Ø Period March-May 2010. Ø Patients with renal and uretral stones indicated for ESWL treatment. Ø Treatments performed with intravenous sedation. Ø Ambulatory procedure. Urología

Method and Materials VARIABLES Ø Age. Ø Double J catheter. Ø Sex. Ø Treatment side. Ø Weight. Ø Fragmentation. Ø Size. Ø Complications. Ø Body mass index. Ø Retreats. Ø Stone sizes and location. Ø Removal rate Urología

Results 33 urinary stones in 30 patients Patients distribution according to age ØAverage: 53, 1 (31 – 76) Urología

Results (n= 30) Patients distribution according to sex Femenino 20% Masculino 80% Urología

Results (n= 33) Patients distribution according to side treated Izquierdo 42% Derecho 58% Urología

Results (n= 33) Patients distribution according to stone localization UPUUreter medio 3% Ureter 3% Superior 9% Pelvis 33% Caliz Inferior 27% Caliz Superior 12% Caliz Medio 12% Urología

Results (n= 33) Patients distribution according to stone size treated > 16 mm 12% 11 a 15 mm 24% 5 mm 9% 6 a 10 mm 55% Urología

• Stone fragmentation: 100 % • Elimination rate: 85% • There were no complications. Urología

Conclusions The double shockwave treatment is a safe and effective procedure. ü It is necesary to perform additional prospective trials on a larger number of patients in order to confirm the results. ü Urología