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The efficacy of the Dornier Doli S lithotripter for renal stones

Christopher C. Hoag, William N. Taylor, Victor A. Rowley

Departments of Urological Sciences and Radiology, University of British Columbia, Vancouver, British Columbia, Canada
Address correspondence to Dr. William N. Taylor, University of British Columbia, Suite 650, 6091 Gilbert Road, Richmond, BC V7C 5L9 Canada

Canadian Journal of Urology 2006, 13(6), 3358-3363.

Abstract

Introduction: There is little documentation of the efficacy of the Doli-S lithotripter. This study investigated the outcome of ESWL with the Doli-S lithotripter on previously untreated renal calculi.
Methods: Over a 12-month period, 105 consecutive patients with renal stones, treated by a single urologist were enrolled in the study. None of the stones were previously treated. Data gathered included stone characteristics and treatment characteristics. Treatment was to an endpoint of either fluoroscopically successful fragmentation or to 2500 shockwaves. Patients were followed with KUBs, ultrasounds, or CT-KUBs to assess residual stone burden. Treatment success was defined as complete clearing of the calculus, or residual fragments of less than 3 mm.
Results: One hundred five patients were treated and 16 were lost to follow-up. One hundred nineteen stones in 89 patients were included in our analysis. Mean follow-up was 115 days. The average stone size (expressed as mean of two measured stone dimensions) was 7.8 mm. After a single lithotripsy treatment, the overall treatment success rate was 47.9%. The left kidney accounted for 58% of the treated stones. Treatment success was greater for left renal stones than right-sided stones (55.1% versus 38.0%, p=0.033). There was no significant difference in treatment success rates for calyceal location of stones. Lower pole stones were treated successfully in 57.9% of cases. Smaller stones (3 mm-10 mm) were more successfully treated than larger stones (10 mm-20 mm) (55.6% versus 24.1%, p<0.001).
Conclusions: Success rates for the Doli-S lithotripter for a single treatment of previously untreated renal stones ranged from 24%-58%, depending on stone size and location. These rates are lower than success rates reported for other lithotripters. Inferior pole calculi had a higher treatment success rate than previously reported. Factors associated with treatment success included smaller stone size, left-sided stones, and ease of fluoroscopic visualization.

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