The purpose of this chapter is to outline the history of the development of shock wave lithotripsy (SWL) of renal and ureteral stones in China and to present our experiences. The technological aspects and clinical use of Chinese lithotripters are further described. Most lithotripters used for SWL in China are indigenously produced. Lithotripter fabrication began relatively early in China; consequently, our lithotripters have developed distinctive technical characteristics that result in an advantageous cost-benefit ratio, shock waves of lower peak pressure and broader focal zone, and a greater opportunity for anesthesia-/analgesia-free and sedation-free SWL. A single ultrasound is the predominant mode for imaging. Today, SWL has become the first-line modality for renal and ureteral stones across China. Our recommended indications for SWL are similar to the European Association of Urology (EAU) and American Urological Association (AUA) guidelines on urolithiasis. In practice, patients often prefer and select SWL in preference to other modes of treatment due to the aforementioned characteristics. The reported results of SWL in China show comparable or even higher stone-free rates at 3 months; however, there is a higher re-treatment rate compared to Western countries’ reported literature. Auxiliary procedures are less used in SWL in China. In our experiences, the most frequent and commonly seen complication post-SWL was temporary hematuria. Other complications were infrequent, and serious complications were rarely reported. In recent years in China, SWL has also been widely used to treat children with renal and ureteral stones. For such cases, serious complications rarely occurred, and the few long-term studies have yet to show any evidence of negative effects of SWL on children’s renal morphology and function.

SWL of Renal and Ureteral Stones: The Chinese Experience

目的 探讨复式脉冲HB-V型低能量体外冲击碎石术(ESWL)治疗各种上尿路结石的效果.方法采用复式脉冲HB-ESWL-VG型低能量碎石机治疗符合ESWL适应证的上尿路结石717例,工作电压3～9 kV.其中直径≤2.0 cm肾结石467例,平均冲击次数2300次;直径≤1.0 cm输尿管结石250例,平均冲击次数2800次.结果上中盏结石排净率89.5%(170/190),复打率13.2%(25/190);下盏结石排净率81.6%(169/207),复打率17.4%(36/207);肾盂结石排净率92.9%(65/70),复打率5.7%(4/70);输尿管结石总排净率95.2%(238/250),总复打率6.4%(16/250).碎石过程中出现轻度疼痛者107例(14.9%),治疗后出现肉眼血尿者687例(95.8%),1～3 d后血尿消失.无肾周血肿等严重并发症.结论复式脉冲低能量ESWL治疗上尿路结石成功率高,复打率低,副作用少,无严重并发症。

Treatment of renal and ureteral calculi with duplex pulse low-energy ESWL (report of 717 cases)

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Treatment of renal and ureteral calculi with duplex pulse low-energy ESWL (report of 717 cases)