Salah M. et al., 2025: Predictors of treatment failure and outcome assessment of extracorporeal shock wave lithotripsy with the Dornier Compact Delta® III Pro: experience from the first 1000 treatments.

Morshed Salah, Maged Al-Ghashmi, Bela Tallai, Abu Baker, Mohammed Ibrahim, Tawiz Gul, Hatem Kamkoum, Salvan Alhabash, Hossameldin Alnawsara, Abdoulhafid Elmogassabi, Maged Alrayashi, Mohammed Ebrahim, Mohamed Abdelkareem, Faisal Ahmed 
Arch Ital Urol Androl. 2025 Jun 30;97(2):13867. doi: 10.4081/aiua.2025.13867 FREE ARTICLE

Abstract

Background: The Dornier Compact Delta® III Pro is a next-generation extracorporeal shock wave lithotripter featuring flat-panel detector technology for enhanced imaging and a compact modular design. This study evaluates treatment outcomes and predictors of failure for this system, representing the first published clinical experience.

Methods: We retrospectively analyzed the first 1,000 consecutive patients treated with the Dornier Compact Delta® III Pro for renal or ureteric stones between May 2022 and November 2023 at a secondary hospital. Stone-free status was assessed via radiography, ultrasonography, or computed tomography (CT) within three months post-treatment. Predictive factors for treatment failure were identified through univariate and multivariate logistic regression analyses.

Results: The cohort had a median age of 37 years (IQR: 32- 44.2) and a body mass index (BMI) of 26 kg/m² (IQR: 24-29). Key characteristics included: prior urologic interventions in 36.6% of patients, single stones in 79.8% (median size 9 mm, IQR: 7-10), a median stone density of 1000 Hounsfield Units (HU) (IQR: 760-1200), and hydronephrosis observed in 55.3% of cases. Initial ESWL success was achieved in 80.5% of cases, increasing to 87.5% following repeat sessions (mean treatments: 1.2). Multivariate analysis identified four independent predictors of treatment failure: prior urologic intervention (adjusted odds ratio [aOR] 2.64, 95% CI 1.75-4.00, p<0.001), multiple stones (aOR 0.45, 95% CI 0.24-0.77, p = 0.011), increased skin-to-stone distance (per cm: aOR 1.18, 95% CI 1.06-1.30, p<0.001), and higher stone density (per 100 HU: aOR 1.12, 95% CI 1.06-1.18, p<0.001).

Conclusions: The Dornier Compact Delta® III Pro achieved an 87.3% stone-free rate with failure predictors consistent with established lithotripsy literature. These findings support the adoption of this device as an effective ESWL system, particularly for institutions prioritizing advanced imaging and a space-efficient design.

Comment Peter Alken

Good results. New brooms always sweep cleaner. Experience with a new device asks for and justifies such a publication, which otherwise does not present anything new.

Peter Alken