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  Discussion on Research Summary: Shock Wave for Uroliths
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DrO

Posted on Friday, Nov 14, 2008 - 9:26 am:

Urethral stones occur when small bladder stones are passed into the urethra and become stuck. This looks like promising therapy to avoid surgery but I do wonder if there is not a high incidence or recurrence since the stones in the bladder are not addressed. Perhaps this is addition to dietary changes to address the type stone might be effective.
DrO

J Vet Intern Med. 2008 Nov-Dec;22(6):1449-51.
The use of radial extracorporeal shockwave therapy in the treatment of urethral urolithiasis in the horse: a preliminary study.

Verwilghen D, Ponthier J, Van Galen G, Salciccia A, Sandersen C, Serteyn D, Grulke S.

Equine Clinic, Faculty of Veterinary Medicine of Liege, Liege 4000, Belgium.

Background: Radial extracorporeal shockwave therapy (ESWT) is widely used in equine practice for the treatment of orthopedic problems. However, its original use as a lithotripsy device in human and canine urology led us to postulate that it could be used as an alternative to the surgical treatment of urethral calculi in horses. Hypothesis: Radial ESWT can easily and safely fragment calculi in the distal urethra of the horse. Animals: Two postmortem cases and 1 live case of obstructive urinary disease admitted at the Veterinary Teaching Hospital of Liege. Methods: A radial shockwave device was directly applied to the urethra in an attempt to fragment calculi. An ex vivo trial was performed on the same retrieved calculi to investigate pressure settings in order to obtain complete fragmentation of the calculus. Results: In all cases, radial ESWT was able to fragment the calculus partially, enabling retrieval of the remaining fragments via the urethra. Much higher pressure settings than those used for in vivo partial fragmentation were necessary to obtain complete destruction of the calculi ex vivo. Conclusions and Clinical Importance: This brief report suggests the use of radial ESWT as a safe and useful alternative to more invasive surgical management of urethral calculi in horses.
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