Audit on extracorporeal shockwave lithotripsy of renal and ureteric stones in Tuen Mun Hospital using Dornier Lithotripter S.

Objectives: We report our results of an audit on extracorporeal shockwave lithotripsy (ESWL) of renal and ureteric stones using the Dornier Lithotripter S (Dornier MedTech, Wessling, Germany). Materials and Methods: We retrospectively reviewed the outcome of ESWL for patients treated between March and December 2003 (pilot). Prospective collection of data was performed for patients treated between October 2004 and March 2005 (re-audit) after an upgrade to the power unit of our shockwave emitter by the manufacturer in September 2004. Patient demographic data, target stone characteristics and treatment outcome were recorded. Analysis of the results between the two periods was made. Results: ESWL was performed on 232 and 220 target stones in the pilot and re-audit periods, respectively. Patient demographic data and stone characteristics were similar between the two periods. Clinical success (stone fragments less than 4 mm in size after one session of ESWL) was achieved in 31% and 61% (stone-free 19% and 38%) of patients in the pilot and re-audit periods, respectively ( P < 0.0001, χ2 test). Patients requiring re-treatment with ESWL to achieve success and auxiliary procedure reduced to 8% and 5%, respectively, in the re-audit period (pilot: 14% and 14%, respectively). The overall complication rate was reduced from 6.2% (pilot) to 3.3% (re-audit). Obstructive complications significantly reduced from 4.8% to 0.5% (pilot vs re-audit, Fisher’s exact test, P = 0.012). Conclusion: Effectiveness of our lithotripter was significantly improved and obstructive complications were significantly reduced after an upgrade to the power unit of the electromagnetic shockwave emitter of our lithotripter. [ABSTRACT FROM AUTHOR]