Mechanical Lithotriptor: A Modern Perspective on an Undervalued Tool

Authors : Halil İbrahim İvelik, Okan Alkış, Mehmet Sevim, İbrahim Kartal, Şeref Coşer, Hüseyin Özgür Kazan, Bekir Aras

Pages : 1-6

Doi:10.54233/endourolbull-1496318

View : 29 | Download : 21

Publication Date : 2025-01-31

Article Type : Research Paper

Abstract :Objective: Bladder stones represent a significant part of urinary stone diseases, predominantly affecting men over 60, especially those with benign prostatic hyperplasia and neurological disorders with urinary dysfunction. Technological advancements have led to various treatment modalities for bladder stones, including transurethral cystolithotripsy, extracorporeal shock wave lithotripsy (ESWL), percutaneous cystolithotripsy, and open cystolithotomy. Mechanical lithotriptors, despite their long history and efficacy, have become less prominent in favor of newer technologies like laser lithotripsy. This study evaluates the effectiveness and safety of mechanical lithotriptors in the treatment of bladder stones. Material and Methods: This retrospective study included 194 patients who underwent surgery for bladder stones at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital between January 2020 and January 2023. Inclusion criteria were male patients over 18 years undergoing endoscopic intervention with available preoperative and postoperative data. Patients who underwent open surgery or had incomplete data were excluded. Surgical methods included lithotripsy using a 30 Watt Holmium Laser and litholapaxy using Mauermayer’s Stone punch lithotriptor. Data on demographics, surgery duration, surgical equipment used, stone size, postoperative complications, and additional treatments were recorded and analyzed using SPSS 24.0. Results: The mechanical lithotripsy group (n=140) had an average age of 65.44±14.74 years, while the laser lithotripsy group (n=54) had an average age of 67.91±14.58 years (p=0.297). In the mechanical group, 117 patients had spinal anesthesia and 23 had general anesthesia, compared to 44 spinal and 10 general anesthesia in the laser group (p=0.728). Additional surgical interventions were required in both groups with no significant difference (p=0.360). The average lithotripsy time was significantly shorter in the mechanical group (52.29±28.86 minutes) compared to the laser group (62.69±22.83 minutes) (p=0.01). No significant differences were found in stone size between groups. Complication rates were comparable, with 133 complication-free cases in the mechanical group and 52 in the laser group (p=0.809). Conclusions: Mechanical lithotripsy offers a shorter surgery duration with comparable complication rates to laser lithotripsy. Despite being underutilized, mechanical lithotriptors continue to be a viable and effective option for treating bladder stones, particularly in centers with surgical expertise. The findings of this study support the safety and efficacy of mechanical lithotriptors in clinical practice, contributing to the existing literature on bladder stone treatment options.
Keywords : urolithiasis, litotripsi, lazer litotripsi, mekanik litotripsi

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