Today’s Solutions: April 29, 2024

If you’ve ever had to painfully pass kidney stones, or if you’ve heard the horrors of others’ experiences and are terrified of having to go through it yourself, then this advancement published in the Journal of Urology about a new non-invasive method to treat patients with kidney stones is sure to pique your interest.

Around 15 percent of people will develop kidney stones at some point in their lives. While in many circumstances, the small stones will pass without any intervention, some patients with more severe cases have to undergo surgery.

For years, surgeons would use sound waves to break up kidney stones utilizing a method called extracorporeal shock wave lithotripsy (ESWL), which involves high-intensity acoustic pulses and usually calls for patients to be sedated or anesthetized. 

Burst wave lithotripsy

The new method, called burst wave lithotripsy (BWL), also uses sound waves but is an improvement upon ESWL because it can be administered using a handheld device and with no sedation. BWL uses short cyclic pulses of ultrasound energy which break down the kidney stones into tiny fragments of 2 mm or even smaller.

The study recruited 19 patients undergoing clinical ureteroscopy for kidney stones to test the novel treatment. BWL was administered to each patient to target three large stones for 10 minutes each, resulting overall in the breaking up 90 percent of the total stone volumes. 39 percent of the targeted stones were completely fragmented into pieces smaller than 2 mm, and the researchers also saw partial fragmentation in 52 percent of the stones.

Ultimately, the researchers determined that the majority of the stone fragments left after BWL treatment should pass naturally without any more medical intervention. BWL treatment also appeared to only cause mild and manageable peripheral tissue injury.

“The ability to non-invasively break stones and expel the fragments in awake patients at first presentation in the ED or clinic has the potential to provide just-in-time treatment leading to a reduction of the overall pain, cost, and resource burden associated with a stone event,” was the researchers’ final assessment in the study. 

Source study: Journal of Urology—Fragmentation of stones by burst wave lithotripsy in the first 19 humans

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