Chang HH. et al., 2022: A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy.
Chang HH, Lin YC, Li CC, Wu WJ, Liou WC, Lin YE, Huang KK, Chen WC.
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Division of General Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Surgery, St. Joseph Hospital, Kaohsiung, Taiwan.
Graduate Institute of Human Resource and Knowledge Management, National Kaohsiung Normal University, Kaohsiung, Taiwan.
CleanWave Medical Co., LTD, Kaohsiung, Taiwan.
Department of Pharmacy and Master Program, Tajen University, No. 20, Weixin Rd., Yanpu Township, Pingtung County, 90741, Taiwan.
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Pharmacy and Master Program, Tajen University, No. 20, Weixin Rd., Yanpu Township, Pingtung County, 90741, Taiwan.
Division of Urology, Department of Urology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan.
Abstract
This study aimed to investigate clinical effectiveness of stone disintegration by using isolation coupling pad ("icPad") as coupling medium to reduce trapped air pockets during extracorporeal shock wave lithotripsy (ESWL). Patients underwent ESWL between Oct. 2017 and May 2018 were enrolled in this clinical observational study. An electromagnetic lithotripter (Dornier MedTech Europe GmbH Co., Germany) was used in this study. Patients were divided into icPad group P1, P2 and semi-gel group C by different coupling medium. The energy level and total number of shock wave (SW) for group P1 and C was set at level 2 and 3000 and group P2 at level 3 and 2500. The successful stone disintegration rate (SSDR) was determined to evaluate the treatment outcome. All patients were evaluated by KUB film and ultrasonography after 90 days. Complications during ESWL were recorded. A total of 300 patients satisfied the inclusion criteria. There were no significant differences in characteristics of patients and stone among three groups. The corresponding SSDRs for patients in group P1, P2 and C was 73.0%, 73.2% and 55.3%, respectively. The SSDR in group P1 was statistically higher than Group C. Comparing to semi-liquid gel, coupling medium using by icPad could achieve better treatment outcome of stone disintegration in ESWL.
BMC Urol. 2022 Apr 12;22(1):56. doi: 10.1186/s12894-022-01001-y. PMID: 35413871. FREE ARTICLE
Comments 1
A simple and effective study with clear-cut results based on previous in vitro experiments (1). Obviously, the coupling pad can be mounted to the shock wave head without trapping of air. In the in-vitro studies the coupling pad was than coupled by spraying a “specified liquid lubricant” (1) on its surface. In the clinical study presented the authors state that they “Spray lubricant to surface of body side before moving bellow to the body”. I wonder what results could have been achieved by spraying the “specific liquid lubricant” directly on the treatment had without using a coupling pad.
1 Wang CS, Li CC, Wu WJ, Liou WC, Lin YE, Chen WC. Newly designed solid coupling medium for reducing trapped air pockets during extracorporeal shock wave lithotripsy_ a phantom study. BMC Urol. 2021 May 14;21(1):79. doi: 10.1186/s12894-021-00847-y. PMID: 33990213; PMCID: PMC8120698.
Peter Alken