Burst Wave Lithotripsy Promising for Breaking Up Kidney Stones

Median of 90 percent comminution of total stone volume observed in the first 19 humans undergoing burst wave lithotripsy
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TUESDAY, April 5, 2022 (HealthDay News) -- For patients undergoing ureteroscopy for kidney stones, burst wave lithotripsy (BWL) administered for a maximum of 10 minutes results in a median of 90 percent comminution of stone volume, according to a study published online March 21 in The Journal of Urology.

Jonathan D. Harper, M.D., from the University of Washington School of Medicine in Seattle, and colleagues conducted a multi-institutional feasibility study involving 19 individuals undergoing clinical ureteroscopy (URS) for at least one stone ≤12 mm. BWL was administered with a handheld transducer during planned URS, either before or after ureteroscopy insertion. Up to three stones were targeted per person, for a maximum of 10 minutes each.

The researchers found that the median stone comminution was 90 percent of stone volume; 21 of 23 stones (91 percent) were fragmented. In nine of 23 stones, complete fragmentation (all fragments ≤2 mm) within 10 minutes of BWL occurred. Likely causative factors for decreased effectiveness in the six least comminuted stones included stones that were larger or smaller than the BWL beam width or introduction of air bubbles from the ureteroscope. Mild reddening of the papilla and hematuria emanating from the papilla were visualized on ureteroscopy.

"New BWL technology successfully fragmented stones of a variety of sizes, locations, and densities to under 2 mm fragments within 10 minutes with negligible tissue injury," the authors write.

Several authors disclosed financial ties to the medical device industry.

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