Shock Waves Can Break Renal Stones. One important problem facing medical science today is the development of new methods of treatment of patients with kidney stones. It usually takes more than one serious operation to remove large and recurrent kidney stones, and there are still no effective medicines for dissolving them. That is why scientists worldwide are looking for new methods of treating this grave and debilitating disease.Since the mid-1970s researchers at the Moscow Radiotechnical Institute of the USSR Academy of Sciences and the Central Air Force Research Hospital jointly with a group of colleagues at the Pirogov Second Moscow Medical Institute have been studying the possibility of crushing kidney stones with the help of supersonic shock waves. Since the speed of a shock wave is altered when it collides with a solid body, a stone surface bombarded by such waves is subjected to pressure forces which destroy or, to be more exact, crush it.
Scientists have been faced with a real challenge. They had not only to design an original crushing device but also to solve a whole range of related problems. They had to work out a technique whereby the crushed stones could freely leave the urethra in a natural way. To ensure the maximum safety of the treatment they had to study the effect shock waves of different intensity have on organs and especially on kidney tissues.
The joint effort resulted in the development of a group of devices known as URATES which make it possible to use a range of shock waves. Trials were carried out on an experimental model. The stones removed from diseased human kidneys were crushed by waves of different parameters. Later the effect of shock waves on tissues and organs was tested in experiments on animals. The result was a new method of crushing kidney stones which ensured the maximum efficiency and safety of treatment. It was called trie erosive method. The method of breaking down the stones into big lumps with the following complete breakdown turned out to be less suitable. Experiments on animals showed that the intensity of shock wave pulses leading to a complete erosive crushing of stones is harmless to kidney tissues and the organism as a whole.
Some minor changes in the kidneys and the surrounding tissues observable through the microscope disappeared on the 20-35th day of the new treatment. Thus, the authors have worked out an essentially new technique of generating shock waves and crushing kidney stones with a minimum of side effects.
Published in Science in the USSR, 1987, no.4. Originally as: N. Lopatkin, M. Shokurov, V. Golubchikov, V. Uvarov, et al. – Extracorporeal Crushing of Kidney Stones by Shock Waves, Urologiya i nefrologiya, 1986, No. 1.