Comparison of the efficacy of Smart Litho Plus and standard extracorporeal shock wave lithotripsy for renal calculi treatment

Supoj  Ratchanon; Sidaporn  Chayochaichana; Atiya  Seeluangsawat; Wattanachai  Ungjaroenwathana; Patranuch  Noppakulsatit

Authors

Supoj Ratchanon Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Sidaporn Chayochaichana Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Atiya Seeluangsawat Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Wattanachai Ungjaroenwathana Division of Surgery, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
Patranuch Noppakulsatit Faculty of Medicine, Thammasat University, Patum Tani, Thailand

Keywords:

Efficacy, Extracorporeal shock wave lithotripsy (ESWL), safety, smart litho plus

Abstract

Background: Urinary stones are one of the most common urological problems in Thailand. Extracorporeal shock wave lithotripsy (ESWL) is one of the most frequently used treatments because it is noninvasive and widely available. However, how the effectiveness of lithotripters with power sources produced in Thailand (Smart Litho Plus) compares with that of standard machines is poorly established.

Objective: This study aimed to evaluate how the effectiveness of Thai-manufactured replacement components compared to those of conventional electromagnetic shock wave systems used in the treatment of kidney stones.

Methods: We conducted a multicenter retrospective cohort study involving 121 patients with renal stones across three sites in Thailand. All subjects underwent urinary tract imaging at their initial visit and were followed up four weeks after stone treatment. A patient was considered stone-free if residual stones measured less than 4 mm.

Results: A significant difference in stone-free rates was recorded between the two groups. The smart Litho Plus group showed a 44.0% stone-free rate, whereas the standard machine group achieved a 64.0% stone-free rate (P = 0.048). However, we noted a difference in the number of shock waves used in the standard machine group.The treatments did not differ significantly in number of adverse events. One patient in the standard machine group developed sepsis after ESWL. Additionally, one patient in the standard machine group and three patients in the Smart Litho Plus group experienced stone street. No findings of renal injury were observed in either group during a follow-up four weeks after imaging.

Conclusion: The standard electromagnetic lithotripter had a higher stone-free rate than the Smart Litho Plus system for renal stone treatment. The Smart Litho Plus system has demonstrated effectiveness and good tolerability. It offers effective and promising stone fragmentation coupled with low adverse event rates.

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