EFFICACY OF IN-VITRO STONE FRAGMENTATION BY EXTRACORPOREAL, ELECTROHYDRAULIC, AND PULSED-DYE LASER LITHOTRIPSY

Fragmentation has become the standard therapy for urinary calculi in t he modern era. Stone fragility as well as position and size are import ant for the determination of a treatment program. To compare the effic acy of stone fragmentation, seven kinds of human urinary calculi with known composition (calcium oxalate monohydrate and dihydrate, dibasic calcium phosphate, uric acid, struvite, calcium phosphate, and cystine ) were treated by three fragmentation techniques commonly used, namely extracorporeal shock wave (SWL), electrohydraulic (EHL), and pulsed-d ye laser lithotripsy. Uric acid, calcium oxalate dihydrate, and calciu m phosphate stones could be destroyed easily by any of these methods. Struvite was soft but sticky and not easy to break into tiny particles . Both dibasic calcium phosphate and calcium oxalate monohydrate stone s were resistant to the laser and EHL; SWL is the treatment of choice. For cystine stones, none of the treatments was satisfactory; SWL was the only way to break them into large pieces.