How to improve lithotripsy and chemolitholysis of brushite-stones: an in vitro study

Because of their resistance to fragmentation, treatment of brushite stones is a big problem. This study was performed to look for an improvement in th erapeutic strategies by using artificial stones made of brushite (Bon(n)-st ones), which are comparable to their natural counterparts. Using an ultraso und transmission technique, longitudinal wave propagation speeds were measu red at different time intervals during treatment with hemiacidrin. From the se and density measurements. transverse wave speed, wave impedance and dyna mic mechanical properties of the artificial stones were calculated. Moreove r, the microhardness of artificial stones was measured and investigations o n shock wave lithotripsy (SWL) combined with initial chemolytic treatment o f the stones were performed. The suggestion was confirmed that stone fragil ity and thus SWL can be improved by varying the physical properties of brus hite stones through treatment with hemiacidrin. Additionally, we demonstrat ed the efficacy of Suby G in dissolving artificial brushite stones using an experimental arrangement simulating the physiological conditions in the up per urinary tract. Moreover, the efficacy of four different intracorporeal lithotripsy devices (electrohydraulic, pneumatic, laser and ultrasound) was tested and it was shown that electrohydraulic lithotripsy seems to be the best system for comminution of brushite stones.