CLINICAL INTRODUCTION OF THE MODULITH SL 10 20 IN 3 PHASES/

The Modulith SL 20 represents a lithotripter with a new electromagneti c cylindric shock wave source. In the stone model, this machine provid es a range of shock wave energy superior to other lithotripters. The d evice includes a combined localization system of ultrasound and fluoro scopy. The clinical introduction of this particular lithotripter was c arried out in the Klinikum Mannheim. During phase I (n = 49) only ultr asound stone localization and reduced peak pressure (18 kV) was used, in phase II (n = 81) the combined localization system was applied and in phase III (n = 182) the peak pressure was additionally increased (2 0 kV). By using x-ray-localization (phase II), the indications for ESW L increased (more ureteric stones, above all, stones localized in the ureter, bigger stone diameter). The disintegration rate increased (75. 3 % in phase I vs 88.5 % in phase III), the stone free rate after thre e months was nearly the same (84.5 in phase II vs 83 % in phase III) a nd the number of auxiliary measures decreased (21 % in phase II vs 14. 2% in phase III). The Modulith meets all requirements of a modern lith otripter, such as efficacy, tolerable pain sensation, multifunctional use (cost reduction) and easy handling.