Extracorporeal Shock Wave Lithotripsy: Experience of the Year with Modulith SLX

Kim, Hee Soo; Seo, Weon Kyo; Park, Choal Hee; Kim, Chun Il; Kim, Kwang Sae

Abstract

Storz Modulith SLX represents a newly developed third generation lithotriptor with an electromagnetic cylinder as shock wave source and a dual localization system consisting of inline ultrasound and an integrated fluoroscope C-arm. We report our initial experience with in situ ESWL treatment of renal and ureteral stones with Modulith SLX. 282 patients with urinary stones were treated. Stones were located in calices or the renal pelvis in 21.4%, in the upper ureter in 50.5%. in the midureter in 6.1% and in the lower ureter in 22.0%. The age range of the patients was 18 to 73 years (mean of 43.8 years). The male to female ratio was 1.6: 1. The size of the stones ranged from 3 to 48mm (mean of 11.6mm). No general or regional anesthesia was required. The average number of shock waves was 3,250 shock/session and the total number of treatment session was 535 (mean of 1.9/person). The success rate was 84.1% in kidney, 92.6% in upper ureter. 83.3% in midureter and 95.4% in lower ureter respectively (overall 90.8%). The success rate was decreased in accordance with increment of stones size : 93.996 for stones of 1- 10mm, 86.2% for 11-20mm, 44.4% for stones larger than 20mm. There was no significant complications. In conclusion, ESWL with Storz Modulith SLX is the first choice of management for urinary stones less than 20mm in diameter regardless of the stone location. And it is an efficient and safe lithotriptor which allows anesthesia-free lithotripsy and treatment for outpatient basis.