We performed endoscopic lithotripsy for 23 urinary stones (21 ureteral and 2 bladder stones) with a pneumatic shockwave unit (Swiss Lithoclast; 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). Immediately after treatment, the 2 patients with bladder calculi and 10 of the 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 were no ureteral perforations in this series. Routine application of double-J stents avoided any serious postoperative complications. Endoscopic lithotripsy with the pneumatic shockwave unit was shown to be highly effective regardless of stone composition. The ltihotripsy probe is easily applied through mini-ureteroscopes.
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