Comparison of the effectiveness and safety of MPL 9000 and Lithostar Modularis shockwave lithotriptors: treatment results of 263 children

In this study, we aimed to compare the treatment results of two different shock wave lithotripsy (SWL) machines used in the management of pediatric urolithiasis. Between January 1993 and October 2004, Dornier MPL 9000 (electrohydraulic) had been used, and since then Siemens Lithostar Modularis (electromagnetic) has been used. The last evaluation was done 3 months after SWL treatment in terms of the success rate, use of anesthesia and complications. A total of 263 children (171 boys and 92 girls), with an age range of 9 months–14 years (mean age 8.1 ± 3.8 years) were included in this study. Of the patients treated with the Dornier MPL 9000, 60.1% (173/104) required general anesthesia and 69 needed sedation. In contrast, for all patients treated with the Lithostar Modularis necessitated only sedo-analgesia (90 children). The hospital stay was shorter for Siemens Lithostar Modularis than those of Dornier MPL 9000 (26.2 vs. 35.5 h, P = 0.03). The success rate for the electromagnetic unit (86.5%) was almost identical that achieved with the electrohydraulic unit (85.2%) in the stones for the different location. Success rates were compared for stone burden subsets, the differences were insignificant for both lithotriptors (P > 0.05, for all). The electromagnetic unit had a significantly higher success rate for distal ureteral calculi (86.2 vs. 54.5%, P = 0.034). The efficiency quotients (EQ) for distal ureteral calculi were significantly different in favor of electromagnetic machine (56 vs. 40%). The complication rates for SWL were not significantly different for electrohydraulic and electromagnetic lithotriptors (8.7 and 6.2%, respectively). This study showed that SWL treatment was effective and safe in pediatric urolithiasis using both electrohydraulic and electromagnetic machines. Electromagnetic machine was more effective than electrohydraulic one for distal ureteral calculi. Additionally, the electromagnetic lithotriptor has significant clinical advantages over the electrohydraulic lithotriptor in terms of anesthesia requirements, hospitalization duration and fluoroscopic targeting.