STORZ MEDICAL – Literature Databases
STORZ MEDICAL – Literature Databases
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Literature Databases

Holmes AF. et al., 2024: Application of novel burst wave lithotripsy and ultrasonic propulsion technology for the treatment of ureteral calculi in a bottlenose dolphin (Tursiops truncatus) and renal calculi in a harbor seal (Phoca vitulina).

Holmes AE, Chew BH, Laughlin R, Buckley J, Kiewice E, Dancel MJ, Blasko D, Wong VKF, Halawani A, Koo KC, Corl D, Fasolo P, Levy O, Thiel J, Bailey MR, Eichman J, Meegan JM, Haulena M.
Dept. of Urology, University of Washington School of Medicine, Seattle, WA, USA.
Department of Urological Sciences, University of British Columbia, Stone Centre at Vancouver General Hospital, British Columbia, Vancouver, Canada.
The Mirage Hotel, Hard Rock International, Las Vegas, NV, USA.
Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea.
SonoMotion, Inc, San Mateo, CA, USA.
Ctr. for Industrial and Medical Ultrasound, Applied Physics Lab, Univ. of Washington, Washington, USA.
Dept. of Urology, University of Washington School of Medicine, Seattle, WA, USA.
Ctr. for Industrial and Medical Ultrasound, Applied Physics Lab, Univ. of Washington, Washington, USA.
National Marine Mammal Foundation, San Diego, CA, USA.
Vancouver Aquarium, Vancouver, BC, Canada.

Abstract

Marine mammals may develop kidney stones, which can be challenging to treat. We describe burst wave lithotripsy (BWL) and ultrasonic propulsion to treat ureteral calculi in a 48-year-old female bottlenose dolphin (Tursiops truncatus) and to reduce renal stone burden in a 23-year-old male harbor seal (Phoca vitulina). BWL and ultrasonic propulsion were delivered transcutaneously in sinusoidal ultrasound bursts to fragment and reposition stones. Targeting and monitoring were performed with real-time imaging integrated within the BWL system. Four dolphin stones were obtained and fragmented ex vivo. The dolphin case received a 10-min and a 20-min BWL treatment conducted approximately 24 h apart to treat two 8-10 mm partially obstructing right mid-ureteral stones, using oral sedation alone. For the harbor seal, while under general anesthesia, retrograde ureteroscopy attempts were unsuccessful because of ureteral tortuosity, and a 30-min BWL treatment was targeted on one 10-mm right kidney stone cluster. All 4 stones fragmented completely to < 2-mm fragments in < 20 min ex vivo. In the dolphin case, the ureteral stones appeared to fragment, spread apart, and move with ultrasonic propulsion. On post-treatment day 1, the ureteral calculi fragments shifted caudally reaching the ureteral orifice on day 9. On day 10, the calculi fragments passed, and the hydroureter resolved. In the harbor seal, the stone cluster was observed to fragment and was not visible on the post-operative computed tomography scan. The seal had gross hematuria and a day of behavior indicating stone passage but overall, an uneventful recovery. BWL and ultrasonic propulsion successfully relieved ureteral stone obstruction in a geriatric dolphin and reduced renal stone burden in a geriatric harbor seal.

Urolithiasis. 2024 Jan 8;52(1):21. doi: 10.1007/s00240-023-01515-6. PMID: 38189835 FREE PMC ARTICLE

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Comments 1

Hans-Göran Tiselius on Monday, 24 June 2024 11:00

This report describes the successful disintegration of ureteral stones in marine animals. From a human clinical point of view this information is of low interest, but the treatment was carried out with burst wave lithotripsy which deserves some attention.
Burst wave lithotripsy and ultrasound propulsion with adequate disintegration (fragments interest in urolithiasis treatment in marine animals carefully should read this report.

Hans-Göran Tiselius

This report describes the successful disintegration of ureteral stones in marine animals. From a human clinical point of view this information is of low interest, but the treatment was carried out with burst wave lithotripsy which deserves some attention. Burst wave lithotripsy and ultrasound propulsion with adequate disintegration (fragments interest in urolithiasis treatment in marine animals carefully should read this report. Hans-Göran Tiselius
Saturday, 13 July 2024