Breaking Up, Treating Kidney Stones Using Burst Wave Lithotrisphy; First-Ever Trial in Humans Exhibit Promising Results

Using focused ultrasound bursts to break up kidney stones, burst wave lithotripsy or BWL offers a promising new method to avoid the expensive and healthcare burden of treatment for kidney stones, a report by University of Washington School of Medicine's Johathan Harper and colleagues specified.

As indicated in a EurekAlert! report, an innovative technique, BWL, may offer an effective, more accessible substitute for the non-invasive treatment of kidney stones.

In this new report, the authors specified that the new BWL technology "successfully fragmented stones" of different sizes, locations, and densities to below two-millimeter fragments within 10 minutes "with negligible tissue injury."

ESWL vs. BWL

Essentially, kidney stones are a very typical condition, affecting one in every 10 Americans at the cost of $10 billion each year. While many stones pass on their own, other treatments are sometimes required.

Some comparatively tiny stones can be treated using a technique, known as extracorporeal shock wave lithotripsy or ESWL, using shock waves to break up the stones to pass on their possibilities. The ESWL approach is carried out in a clinic or hospital, usually seated with the patient.

Opposite the shock waves used in ESWL, the BWL method uses "short harmonic bursts" of ultrasound energy, potentially enabling the stones to be broken up in a shorter procedure minus the need to sedate or put a patient on anesthesia. Pre-clinical research backed the efficacy of BwL in breaking up experimental stones of various sizes and compositions.

Preliminary Studies in Human Patients with Kidney Stones

In the succeeding step in developing the procedure, Harper and his colleagues conducted preliminary studies in human patients with kidney stones.

The patients underwent a surgical procedure, also known as ureteroscopy, to treat larger stones. Prior to the treatment, the stones were treated with a short period of BWL, not going beyond 10 minutes.

Using the ureteroscope, the study investigators could directly observe how effective the waves were in working to break up the stones. They observed, too, any injury to the kidney tissues. In the Journal of Urology study, BWL was applied to 19 patients to targe 25 confirmed stones in all.

As a whole, a median of 90 percent of the stone volume was completely comminuted or broken up within the short period of treatment. Thirty-nine percent of stones were completely fragmented, while 52 percent were partly fragmented.

BWL Essential for Managing Kidney Stones

As specified in a similar Medical Xpress report, BWL could be an essential practical advance in managing kidney stones for many reasons.

Many patients make multiple visits to the emergency department while they wait for definitive treatment for their kidney stones, frequently needing opioids for pain management. On the other hand, some patients need repeated treatment, even following ESWL or surgery.

In this new study, the researchers specified that the ability to noninvasively break stones and expel the fragments in awake patients at presentation in the emergency department or clinic has the potential to provide just-in-time treatment resulting in a reduction of the overall pain, cost, as well as resource burden linked to a stone occurrence.

The new findings, the researchers added, are a step toward an "office-based lithotripsy for awake patients." The study investigators also said they are planning further research to determine if the BWL approach can meet their ultimate goal of a non-invasive, half-hour treatment in need of anesthesia.

Related information about shockwave lithotripsy is shown on St. Michael's Hospital's YouTube video below:

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