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Raskolnikov D, Bailey MR, Harper JD. Recent Advances in the Science of Burst Wave Lithotripsy and Ultrasonic Propulsion. BME FRONTIERS 2022; 2022. [PMID: 37090444 PMCID: PMC10117400 DOI: 10.34133/2022/9847952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Nephrolithiasis is a common, painful condition that requires surgery in many patients whose stones do not pass spontaneously. Recent technologic advances have enabled the use of ultrasonic propulsion to reposition stones within the urinary tract, either to relieve symptoms or facilitate treatment. Burst wave lithotripsy (BWL) has emerged as a noninvasive technique to fragment stones in awake patients without significant pain or renal injury. We review the preclinical and human studies that have explored the use of these two technologies. We envision that BWL will fill an unmet need for the noninvasive treatment of patients with nephrolithiasis.
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Affiliation(s)
- Dima Raskolnikov
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Michael R. Bailey
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Jonathan D. Harper
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
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Hall MK, Samson PC, Kessler R, Lehnhardt K, Easter B, Thiel J, Wessells H, Bailey MR, Harper JD. Pearl-unjammed: the Seattle stone maneuver for ureteropelvic junction urolithiasis. J Am Coll Emerg Physicians Open 2020; 1:252-256. [PMID: 32613205 PMCID: PMC7329006 DOI: 10.1002/emp2.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Renal colic encounters are common; in the United States alone, they represent greater than one million annual emergency department (ED) visits. Most of these stones are managed conservatively with a trial of passage. However, some lead to repeat colic episodes, secondary ED visits, increased anxiety, and increased cost. Of the 5%-10% of symptomatic stones that become lodged at the ureteropelvic junction and are larger than 5 mm, most require operative intervention. In the process of executing a NASA-funded study of ultrasonic repositioning of kidney stones, the subject was administered fluid to dilate the collecting system, placed in Trendelenburg bed positioning, and rolled to both sides. During this process a symptomatic, obstructing 9-mm ureteropelvic junction stone moved back into the kidney's lower pole/infundibulum and symptoms were immediately resolved. The patient remained asymptomatic for a period of 5 weeks at which point elective intervention was scheduled. This case demonstrates that ureteropelvic junction stones may be repositioned in a non-invasive manner, turning a stone that requires urgent intervention into one that can be managed electively.
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Affiliation(s)
- M Kennedy Hall
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Patrick C Samson
- Department of Urology, Weill Medical College of Cornell University, New York, New York
| | - Ross Kessler
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Kris Lehnhardt
- Department of Emergency Medicine and Center for Space Medicine, Baylor College of Medicine, Houston, Texas.,Exploration Medical Capability, Human Research Program, NASA Johnson Space Center, Houston, Texas
| | - Benjamin Easter
- Exploration Medical Capability, Human Research Program, NASA Johnson Space Center, Houston, Texas.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Jeff Thiel
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Hunter Wessells
- Department of Urology, University of Washington School of Medicine, Seattle, Washington
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington.,Department of Urology, University of Washington School of Medicine, Seattle, Washington
| | - Jonathan D Harper
- Department of Urology, University of Washington School of Medicine, Seattle, Washington
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