An article published in the Journal of Urology is reporting on the first 19 humans treated with a new non-invasive method designed to break up kidney stones using sound waves. The method, dubbed burst wave lithotripsy (BWL), successfully fragmented the majority of kidney stones, promising a non-surgical way to treat patients with this common condition.
Up to 15 percent of people will experience kidney stones at some point in their life. Many cases of small stones are known to pass spontaneously and without any intervention, however, some patients require surgical intervention to avoid permanent kidney damage.
For several decades surgeons have used sound waves to break up kidney stones in a method called extracorporeal shock wave lithotripsy (ESWL). The method involves high intensity acoustic pulses and generally requires patients to be sedated or even anesthetized.
This new method differs from ESWL in that it can be administered in more informal settings using a handheld device, and with no sedation. Burst wave lithotripsy uses short cyclic pulses of ultrasound energy to break kidney stones down into fragments equal to, or smaller than, 2 mm.
The new study is a the largest published report on the efficacy of the novel method in human patients. Nineteen patients undergoing clinical ureteroscopy for kidney stones were recruited.
BWL was administered during the surgical procedure, targeting up to three large stones (≤12 mm) in each patient for around 10 minutes per stone. Overall the study reported 90 percent of the total stone volume was broken up, with 39 percent of the targeted stones completely fragmented into pieces smaller than 2 mm and partial fragmentation seen in 52 percent of the stones.
The researchers say the majority of stone fragments left after BWL treatment should naturally pass with no further medical intervention. The BWL treatment was also found to cause only mild and manageable peripheral tissue injury.
BWL still needs more research before it is widely deployed in clinics. Optimal treatment methods need to be investigated and the ultimate goal is to develop a treatment that can be quickly administered in office environments when patients first present with kidney stones.
“The ability to noninvasively 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,” the researchers concluded in the study.