Renal Stone Clinical Trial
Official title:
Impact of Different Shock Wave Release Frequencies on Disintegration of Renal Stones in Assuit Urology & Nephrology University Hospital
The impact of different frequencies on pattern of disintegration of renal stones
- Prior to the introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980, the
only treatment available for calculi that could not pass through the urinary tract was
open surgery. Since then, ESWL has become the preferred tool in the urologist's
armamentarium for the treatment of renal stones, , ESWL is minimally invasive, exposes
patients to less anaesthesia, and yields equivalent stone-free rates in appropriately
selected patients.
- The efficacy of ESWL lies in its ability to pulverize calculi in vivo into smaller
fragments, which the body can then expulse spontaneously. Shockwaves are generated and
then focused onto a point within the body. The shockwaves propagate through the body
with negligible dissipation of energy (and therefore damage) owing to the minimal
difference in density of the soft tissues. At the stone-fluid interface, the relatively
large difference in density, coupled with the concentration of multiple shockwaves in a
small area, produces a large dissipation of energy. Via various mechanisms, this energy
is then able to overcome the tensile strength of the calculi, leading to fragmentation.
Repetition of this process eventually leads to pulverization of the calculi into small
fragments that the body can pass spontaneously and painlessly.
- It is well recognized that the popularity of extracorporeal shock wave lithotripsy
(SWL), despite its non-invasive character, has decreased during recent years. This is
partly explained by the technological achievements in endoscopy and urologists'
enthusiasm for such procedures. Another explanation is that many urologists have been
insufficiently successful with SWL. The latter effect might to some extent be a result
of the performance of the lithotripter used, but in too many cases, it is evident that
the principles of how shock wave lithotripsy should be carried out are poorly
appliedical aspect
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