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Ultrasonic propulsion of kidney stones
#MMPMID26845428
May PC
; Bailey MR
; Harper JD
Curr Opin Urol
2016[May]; 26
(3
): 264-70
PMID26845428
show ga
PURPOSE OF REVIEW: Ultrasonic propulsion is a novel technique that uses short
bursts of focused ultrasonic pulses to reposition stones transcutaneously within
the renal collecting system and ureter. The purpose of this review is to discuss
the initial testing of effectiveness and safety, directions for refinement of
technique and technology, and opinions on clinical application. RECENT FINDINGS:
Preclinical studies with a range of probes, interfaces, and outputs have
demonstrated feasibility and consistent safety of ultrasonic propulsion with room
for increased outputs and refinement toward specific applications. Ultrasonic
propulsion was used painlessly and without adverse events to reposition stones in
14 of 15 human study participants without restrictions on patient size, stone
size, or stone location. The initial feasibility study showed applicability in a
range of clinically relevant situations, including facilitating passage of
residual fragments following ureteroscopy or shock wave lithotripsy, moving a
large stone at the ureteropelvic junction with relief of pain, and
differentiating large stones from a collection of small fragments. SUMMARY:
Ultrasonic propulsion shows promise as an office-based system for
transcutaneously repositioning kidney stones. Potential applications include
facilitating expulsion of residual fragments following ureteroscopy or shock wave
lithotripsy, repositioning stones prior to treatment, and repositioning
obstructing ureteropelvic junction stones into the kidney to alleviate acute
renal colic.
free
free
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