Ultrasound waves may soon be used to break up kidney stones, scientists say

A technique that destroys kidney stones with ultrasound waves may provide a noninvasive treatment option for the painful condition, according to the first human study published in the journal Neurology. Journal of Urology,

Jonathan Harper of the University of Washington and his colleagues found that the new technique, burst wave lithotripsy (BWL), holds promise for reducing the cost and health care burden of treating kidney stones.

“The new BWL technique successfully fractured stones of a variety of sizes, locations and densities into two-millimetre pieces within 10 minutes, with minor tissue injury,” the study said. BWL may allow in-office treatment for kidney stones.

Currently, 1 in 10 Americans is diagnosed with kidney stones at a treatment cost of $10 billion per year. Sometimes, kidney stones pass naturally through the urine, often causing great pain, though often requiring medical treatment.

Small stones can be broken up with the Extracorporeal Shock Wave Lithotripsy (ESWL) technique, which uses shock waves to shatter the stones and promote their natural passage through the body. Patients usually undergo sedation during the procedure, which is usually performed in a hospital or clinic.

Large kidney stones, as shown here, usually need to be broken down into smaller pieces so they can be passed naturally.
Tsester/Public Domain

Unlike ESWL, BWL technology uses short harmonic bursts of ultrasound energy, breaking up stones more quickly and without sedation or anesthesia. Pre-clinical studies have shown that it broke experimental stones of various sizes and compositions. According to Harper and his colleagues, their results “are a step toward office-based lithotripsy for awake patients.”

Participants in the study were 19 patients, among whom 25 with confirmed stones were undergoing a surgical procedure called ureteroscopy, which is used to treat large stones. Instead, they were previously treated for BWL with little exposure for more than 10 minutes.

According to Johns Hopkins University, the ureteroscopy procedure involves passing a small telescope, called a ureteroscope, through the urethra and bladder, and down the ureter to address the stone.

It is usually done under general anesthesia and lasts one to three hours. Smaller stones can be completely removed from the ureter with a basket-like instrument, while larger stones are fragmented, usually with a laser. These pieces are then removed.

The researchers used the utroscope to observe the results of the BWL treatment.

A median of 90 percent of stone volumes were completely ruptured within the brief treatment period. Twenty-nine percent of the stones were completely fractured, while 52 percent were partially fractured. Most of the pieces were small enough to pass through without significant pain. In addition to mild bleeding, the study found that there was little or no tissue injury due to the BWL procedure.

Burst Wave Lithotripsy Graphic
A graphic demonstrating the use of burst wave lithotripsy in the treatment of kidney stones.
Harper et al., 2022/The Journal of Urology

Researchers believe the new procedure is an important development in the treatment of kidney stones. When patients go to the emergency room, they are often given opioid painkillers while they wait for treatment. And some require multiple treatments after ESWL and surgery.

“The ability to break up stones non-invasively at first presentation to the ED or clinic and take out fragments in awake patients has the potential to provide appropriate timely treatment thereby reducing the overall pain, cost and resource burden associated with a stone.” phenomenon,” wrote the researchers.

The team will conduct further studies to reach their goal of “30-minute non-invasive treatment in the clinic without anesthesia.” The BWL technology has been licensed for development of a commercial version which is currently in separate clinical trials.

This story was provided to Greeley Tribune zengar news,

Leave a Comment

%d bloggers like this: