ENDOSCOPIC LITHOTRIPSY WITH A PNEUMATIC S HOCKWAVE UNIT (SWISS LITHOCLAST) THROUGH MINI-URETEROSCOPES

We performed endoscopic lithotripsy for 23 urinary stones (21 ureteral and 2 bladder stones) with a pneumatic shockwave unit (Swiss Lithocla st; EMS, Angiomed), for the first time applying the probe through the tangential working channel of a semirigid 6.9-Fr ureteroscope (Circon, ACMI). Disintegration was successful in all stones (5-24 mm). Immedia tely after treatment, the 2 patients with bladder calculi and 10 of th e patients with ureteral stones (47.6%) were stone free, while another 5 had residual fragments <3 mm. Migration of fragments in 4 patients (19%) led to subsequent extracorporeal shock wave lithotripsy. There w ere no ureteral perforations in this series. Routine application of do uble-J stents avoided any serious postoperative complications. Endosco pic lithotripsy with the pneumatic shockwave unit was shown to be high ly effective regardless of stone composition. The ltihotripsy probe is easily applied through mini-ureteroscopes.