Experience with the Dornier lithotriptor MPL 9000-X for the treatment of vesical lithiasis

Between February 1994 and March 1995, 52 patients (48 men and 4 women) with vesical lithiasis were treated by extracorporeal shock wave lithotripsy (ESWL), using the MPL 9000-X Dornier lithotriptor. Twenty-five patients showed bladder outlet obstruction. In 9 patients, there was evidence of associated bladder neuropathy. In 6 patients, calculi presented idiopathically in normal bladders. Two patients had silent migration of ureteral calculi and increase in bladder volume, 8 were high risk and 2 others refused other methods of up to date treatment. Vesical stone sizes ranged from 10 to 22 mm in greatest diameter (mean 15 mm). The treatments were performed without the use of anaesthesia and on an outpatient basis. Complete fragmentation was achieved after a single session in 46 patients and 3 required 2 sessions. Postoperative adjunctive endourological procedures included cystoscopy in 9 patients and urethroscopy in 1 patient for evacuation of stone fragments. The overall stone-free rate was 94.2% (49 out of 52 patients) with ESWL and adjunctive measures as needed. No major complications were noted. We find ESWL with the MPL 9000-X lithotriptor to be a simple, effective and safe modality for the treatment of most patients with vesical lithiasis, especially in high risk patients.