1464 CLINICAL AND ECONOMIC IMPACT OF IMPLEMENTATION OF SLOW SHOCK WAVE LITHOTRIPSY FOR THE TREATMENT OF URINARY CALCULI

Abstract Aim: To analyze the impact of slowing the shockwave delivery during extracorporeal shockwave lithotripsy (SWL) on the clinical patient outcome and the cost of delivering this service in a community practice. Patients and Methods: The data from 1745 consecutive SWL procedures were analyzed at a freestanding surgery center. About 872 treatments were performed at 120 shocks per minute (fast rate [FR]) and 873 were performed at 60 shocks per minute (slow rate [SR]) using a Lithotron machine. Ninety-nine percent of the patients received 3000 shocks. The location and stone size were similar in both groups. Stone-free rate was determined by a plain film of the abdomen at follow-up. Results: The clinical outcome of SR shows a statistically significant improvement in stone-free rate on all stone locations and stone sizes except for those smaller than 25 mm2. The need for additional secondary treatment decreased from 35.4% to 18.2%. The anesthesia time increased from 26 to 50 minutes per treatment. On the ...