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The 3rd‐generation electromagnetic (EM) shock wave lithotripters often have narrow focal width and high peak pressure compared to the original Dornier HM‐3. In addition, the pressure waveform produced by a typical EM lithotripter has a secondary compressive wave following the tensile component that suppresses lithotripter pulse induced cavitation, which may impact negatively on stone comminution. These characteristic changes in the modern EM lithotripters may contribute in part to their reduced effectiveness observed clinically. To overcome these two drawbacks, we have designed a new acoustic lens for the Siemens Modularis EM lithotripter that produces an idealized pressure waveform similar to that of the HM‐3 with broad focal width and low peak pressure. At acoustic pulse energy of 53 mJ, the new lens design enlarges the −6 dB focal width of the Modularis by 47% while significantly reducing the second compressive wave in the lithotripter pulse throughout its focal plane. After 2000 shocks, in vitro commi...

The effect of beam size on stone comminution in the Dornier HM‐3 lithotripter were investigated using a modified reflector (MR), which was developed to produce an acoustic field with higher peak pressure and smaller beam size compared to the original reflector (OR) of the HM‐3. The acoustic fields produced at 20 kV by the MR in the focal plane, and by the OR in the focal and pre‐focal plane (z = −15 mm) were characterized using a light spot hydrophone. The efficiencies of stone comminution in a mesh holder were similar, but the corresponding values produced by using the MR in a membrane holder were significantly lower than those produced by the OR in the focal and pre‐focal planes. These results suggest that a broad beam size could increase stone comminution efficiency when fragments are spreading out or moving due to respiratory motion in a large area during SWL. In contrast, when stone fragments are confined and well aligned to lithotripter focus the beam size may not influence significantly the treatme...