Treatment Options

Pneumatic Mechanical Lithotripsy

Several pneumatic lithotriptors are in current use. In the Swiss Lithoclast compressed air repeatedly drives a metal bullet onto a metal rod creating a chisel and hammer effect that fragments the targeted stone. The Lithoclast and the Browne Pneumatic Impactor (BPI) are capable of fragmenting all stones, irrespective of their size or composition. Unlike laser and ultrasonic lithotriptors, there are no thermal sequelae.

Pneumatic lithotripsy utilizes compressed air forcing a metal projectile against a probe, which causes the probe to move back and forth very quickly, resulting in a "jackhammer" effect to fragment the stone.

Advantages of Pneumatic Lithotripsy

  1. Simple to use
  2. No disposable parts
  3. Easy to maintain
  4. Relatively inexpensive
  5. Pneumatic lithotripsy comes in both rigid and flexible fibers and can be utilized in rigid and flexible ureteroscopy

Disadvantages

  1. A tendency to propel the stone or fragmented stone toward the upper ureter
  2. Flexible fibers may have some decline in force compared to a standard rigid probes

Suggested readings
Grocela JA, Dretler SP. Intracorporeal lithotripsy: Instrumentation and development. Urol Clin North Am 1997, 24:1:13-23.

Tawfick ER, Grasso M, Bagley DH. Initial use of Browne pneumatic impactor. J Endourol 1997, 11:2:121-124.

Denstedt JD, Razvi HA. Fox MJ: Ureteral lithotripsy with the electromechanical impactor. J Endourol 1995; 9(6): 453-455.

Benizri A, Guiter J, Averous M, et a]: Treatment of 150 ureteric calculi with the lithoclast. Euro Urol 1994; 26(3): 212-215.

Montserrat 0, Torrent V, Quer N, et al: Treatment of ureteral lithiasis with lithoclast: Analysis of our experience. Archivos Espanoles de Urologia 1996: 49(7): 751-754.

Leidi GL. Berti GL, Canclini L, et al: Ureteroscopy and stone lithotripsy with lithoclast: Personal experience. Archivio Italiano de Urologia, Andrologia 1997 69(3): 181-183.

Terai A, Takeuchi H, Terachi T, et al: intracorporeal lithotripsy with The-Swiss Lithoclast. Int J Urol 1996~ 3(3): 184-186.

Smet C, Laguna Pes P, Salvador Bayarri J, et al: Endoscopic lithotripsy by means of lithoclast. Archivos Espanoles de Uroloaia 1995; 48(6): 621-624.

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