International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy.

Different international associations have proposed their own guidelines on urolithiasis. However, the focus is primarily on an overview of the principles of urolithiasis management rather than step-by-step technical details for the procedure. The International Alliance of Urolithiasis (IAU) is releasing a series of guidelines on the management of urolithiasis.

Optical coupling control: an important step toward better shockwave lithotripsy.

Background: In modern "dry" lithotripters, shockwaves are generated in a membrane-covered water cushion that is then coupled to the patient.To limit energy loss, a coupling agent, usually ultrasound gel, is used in this acoustic interface. During the coupling process, air pockets are inevitably trapped in the coupling area, which subsequently remains invisible to the operator.

Extracorporeal shock wave lithotripsy today.

Even 32 years after its first introduction shockwave lithotripsy (SWL) remains a matter of discussion and controversy. Since the first SWL in 1980, millions of treatments have been performed worldwide. To this day SWL remains the least invasive of all stone treatments and is considered the treatment modality of first choice for the majority of urinary stones.

Emphysematous cystitis: report of an atypical case.

We report the atypical case of a nondiabetic 66-year old male with severe abdominal pain and vomiting who was found to have emphysematous cystitis. Of all gas-forming infections of the urinary tract emphysematous cystitis is the most common and the least severe. The major risk factors are diabetes mellitus and urinary tract obstruction.

Twenty years of single center experience in ESWL 1987-2007: an evaluation of 3079 patients.

Introduction: Since 1987 we have consecutively operated five different Dornier lithotriptors in the management of lithiasis at all levels of the urinary tract. At the time of usage of each machine we periodically evaluated the treatment results in order to eventually adapt treatment strategies to improve results. None of these evaluations comprised the totality of patients treated on a certain machine during the entire period it was in use.

Use of tramadol drip in controlling renal colic pain.

Background And Purpose: Although the continuous perfusion of antispasmodic drugs has been the traditional mainstay in the treatment of renal colic, the results more often than not are unsatisfactory. Our hypothesis was that a continuous intravenous (IV) drip of tramadol would be an effective and safe alternative.

Patients And Methods: In this prospective study, 300 patients with renal colic were randomized into four treatment groups, single blind for the patients.

Modern approach to ureteral stones.

Urolithiasis is a very common affliction of mankind. In western countries incidence is increasing steadily. An increasing proportion of patients are presenting with ureteral stones, of which renal colic most often is the first complaint and the most common reason for an emergency visit to a urologist.

In situ SWL of ureteral stones: comparison between an electrohydraulic and an electromagnetic shockwave source.

Purpose: To compare the influence of different shockwave emitters on treatment efficacy for SWL of ureteral stones in situ.

Patients And Methods: From January 1, 1990, until August 31, 1998, we treated 175 ureteral stones in situ 9 to 252 mm(2) (mean 55.2 mm(2)) using X-ray targeting on a Dornier MPL 9000 X lithotripter, a spark gap machine.

Patient-controlled analgesia during SWL treatments.

Purpose: To identify the factors that influence analgesic consumption during SWL on the Dornier Lithotripter U/50.

Patients And Methods: In Group 1 (N = 152), analgesia was induced with propofol 0.8 mg/kg and alfentanil 8 microg/kg.

Consecutive experience with four Dornier lithotripters: HM4, MPL 9000, compact, and U/50.

Patients And Methods: Since 1987, we have consecutively used four Dornier lithotripters in our Urology Department: an HM4 (N = 319 cases), MPL 9000X (N = 752), Compact (N = 546), and U/50 (N = 427). Both the HM4 and the MPL 9000X are electrohydraulic machines, whereas the Compact and the U/50 are electromagnetic lithotripters.

Results: Treatment strategies prove to be influenced largely by the available imaging modalities: only fluoroscopy on the HM4, ultrasound and fluoroscopy with a movable C-arm on the MPL 9000X and Compact, and simultaneous integrated fluoroscopy and ultrasound on the U/50.

The Dornier Lithotripter U/15/50: a multifunctional and multidisciplinary workstation.

Since February 1, 1996, we have been using the Dornier Lithotripter U/50 in our Stone Center, first and foremost for SWL treatment of urinary lithiasis. In a limited series of 136 patients treated from February 1, 1996, through April 30, 1996, we obtained encouraging results: the average retreatment rate for stones of all sizes was 13.2%, and the stone-free rate at 3 months was 90.

Operative strategy in laparoscopic nephrectomy.

Nephrectomy is a debilitating procedure because of the trauma to the abdominal wall. Laparoscopy could be a solution in this matter. Four patients underwent laparoscopic nephrectomy.

Experience with the Dornier HM4 and MPL 9000 lithotriptors in urinary stone treatment.

From November 17, 1987 until August 20, 1988 we operated a fluoroscopy guided Dornier HM4 kidney lithotriptor. This lithotriptor subsequently was replaced by the ultrasound guided Dornier MPL 9000 lithotriptor, a multipurpose machine for urinary and biliary stone treatment. With the Dornier HM4 device we performed 447 treatment sessions in 319 patients (483 stones).

The Rosen prosthesis: a bad experience.

Between September 1977 and September 1980 we implanted 4 Rosen inflatable incontinence prostheses in 4 men with urinary incontinence. Twelve operations were necessary on these 4 patients to assure them to be continent during a total of 43 months. Because of the great number of complications we no longer use the Rosen prosthesis.

A review of 357 bilateral vasectomies for male sterilization.

A series of 357 bilateral vasectomies for male sterilization performed over a period of 18 months was reviewed to assess the safety of the surgical procedure, the onset of sterility, and the acceptability of the procedure. The surgical procedure proved to be safe with few complications, the patients became sterile after approximately 82 days, and the acceptability was very good. A group of 34 patients (10.

Urinary carcinoembryogenic antigen (CEA) in the diagnosis and follow-up of bladder carcinoma.

The level of urinary carcinoembryogenic antigen (CEA) was evaluated in the diagnosis and follow-up of urothelial carcinoma of the bladder. Urinary CEA concentration, cystoscopic findings and the histopathology of an eventually resected bladder tumour were correlated in 177 cases. The sensitivity proved to be 34%, the specificity 82%.