1941 A PROSPECTIVE RANDOMIZED TRIAL COMPARING THE MODIFIED HM3 WITH THE MODULITH® SLX-F2 LITHOTRIPTER

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You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111941 A PROSPECTIVE RANDOMIZED TRIAL COMPARING THE MODIFIED HM3 WITH THE MODULITH® SLX-F2 LITHOTRIPTER Pascal Zehnder, Beat Roth, Frederic Birkhaeuser, Silvia Schneider, Rolf Schmutz, George Thalmann, and Urs Studer Pascal ZehnderPascal Zehnder Bern, Switzerland More articles by this author , Beat RothBeat Roth Bern, Switzerland More articles by this author , Frederic BirkhaeuserFrederic Birkhaeuser Bern, Switzerland More articles by this author , Silvia SchneiderSilvia Schneider Bern, Switzerland More articles by this author , Rolf SchmutzRolf Schmutz Bern, Switzerland More articles by this author , George ThalmannGeorge Thalmann Bern, Switzerland More articles by this author , and Urs StuderUrs Studer Bern, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2122AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The efficacy of first compared to last generation lithotripters is unknown. We compared clinical effectiveness and complications of the modified Dornier HM3 versus the Storz Modulith® SLX-F2 for extracorporeal shock wave lithotripsy (ESWL). METHODS Prospective randomized single center trial. Patients with solitary stones were stratified according to localisation (kidney stones, ureteral stones or lower calyx stones) and stone size. Irrespective of the location, anyone with >1 stone was assigned to the group with multiple stones. All patients underwent shock wave treatments under anaesthesia. Stone disintegration, residual fragments, dilatation of the collecting system, colic pain and possible kidney hematoma were evaluated 1 day and 3 months after ESWL. Complications, ESWL retreatments and adjuvant procedures were documented. RESULTS 405 patients were treated with the HM3, 415 with the SLX-F2. HM3 treatment required fewer shock waves, its fluoroscopy time was shorter. Solitary kidney stones: HM3 produced rather higher stone free rate (p=0.06) on day 1. Stone-free rates were similar at 3 months (HM3: 74% vs. SLX-F2: 67%; p=0.36). Solitary ureteral stones: Higher stone-free rate at 3 months with HM3 (HM3: 90% vs. SLX-F2: 81%; p=0.05). Solitary lower calyx stones: Equal stone-free rate of 63% at 3 months. Multiple stones: HM3 caused higher stone-free rate at 3 months (HM3: 64% vs. SLX-F2: 44%; p=0.003). Overall, HM3 led to fewer ESWL retreatments (HM3: 7% vs. SLX-F2: 11%; p=0.02) and fewer kidney hematomas (HM3: 1% vs. SLX-F2: 3%; p=0.02). CONCLUSIONS The present clinical trial is to our knowledge the largest prospective randomized single institution trial analyzing two different lithotripters. In patients with solitary kidney and solitary lower calyx stones, equally good results were obtained irrespective of lithotripter used. In contrast, the HM3 lithotripter caused higher stone-free rates for solitary ureteral and multiple stones, fewer kidney hematomas and lower ESWL retreatment rates than the SLX-F2. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e776 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Pascal Zehnder Bern, Switzerland More articles by this author Beat Roth Bern, Switzerland More articles by this author Frederic Birkhaeuser Bern, Switzerland More articles by this author Silvia Schneider Bern, Switzerland More articles by this author Rolf Schmutz Bern, Switzerland More articles by this author George Thalmann Bern, Switzerland More articles by this author Urs Studer Bern, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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