Facilitated clearance of small, asymptomatic, renal stones with burst wave lithotripsy and ultrasonic propulsion

No AccessJournal of UrologyTranslational Research Article17 Mar 2025Facilitated clearance of small, asymptomatic, renal stones with burst wave lithotripsy and ultrasonic propulsion Jonathan D. Harper, Barbrina Dunmire, Jeff Thiel, Barbara H. Burke, Yak-Nam Wang, Stephanie Totten, John C. Kucewicz, Adam D. Maxwell, M. Kennedy Hall, Arturo E. Holmes, Christina Popchoi, James E. Lingeman, Alana C. Desai, Robert M. Sweet, Manjiri Dighe, Branda J. Levchak, Claire C. Yang, Michael R. Bailey, and Mathew D. Sorensen Jonathan D. HarperJonathan D. Harper Department of Urology, University of Washington, Seattle, WA, USA , Barbrina DunmireBarbrina Dunmire Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , Jeff ThielJeff Thiel Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , Barbara H. BurkeBarbara H. Burke Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA , Yak-Nam WangYak-Nam Wang Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , Stephanie TottenStephanie Totten Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , John C. KucewiczJohn C. Kucewicz Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , Adam D. MaxwellAdam D. Maxwell Department of Urology, University of Washington, Seattle, WA, USA , M. Kennedy HallM. Kennedy Hall Department of Emergency Department, University of Washington School of Medicine, Seattle, WA, USA , Arturo E. HolmesArturo E. Holmes Department of Urology, University of Washington, Seattle, WA, USA , Christina PopchoiChristina Popchoi Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA , James E. LingemanJames E. Lingeman Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA , Alana C. DesaiAlana C. Desai Department of Urology, University of Washington, Seattle, WA, USA , Robert M. SweetRobert M. Sweet Department of Urology, University of Washington, Seattle, WA, USA , Manjiri DigheManjiri Dighe Department of Radiology, University of Washington, Seattle, WA, USA , Branda J. LevchakBranda J. Levchak Seattle Institute for Biomedical and Clinical Research, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA , Claire C. YangClaire C. Yang Department of Urology, University of Washington, Seattle, WA, USA Section of Urology, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA , Michael R. BaileyMichael R. Bailey Correspondence and reprints: Michael Bailey, Ph.D. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 49th St. Seattle, WA, USA ([email protected]) +1 206-619-2035 https://orcid.org/0000-0003-0491-6465 , and Mathew D. SorensenMathew D. Sorensen Department of Urology, University of Washington, Seattle, WA, USA Section of Urology, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA View All Author Informationhttps://doi.org/10.1097/JU.0000000000004533AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: We tested feasibility of burst wave lithotripsy (BWL) and ultrasonic propulsion to noninvasively fragment and expel small, asymptomatic, renal stones in awake participants. Methods: Adult patients suspected of having 2-7 mm stones were consented and screened for eligibility. BWL and ultrasonic propulsion were applied to up to three stones in one kidney of qualifying participants for a 30-minute total exposure. Participants completed a computed tomography (CT) scan and the Wisconsin stone quality-of-life questionnaire (WISQOL) within 90 days before and 120 days after the procedure. Participants were contacted weekly for 3 weeks following the procedure to assess adverse events (AEs). Outcomes included 1) no fragment > 2 mm, 2) unanticipated healthcare visits, 3) change in stone volume, 4) reported AEs, and 5) WISQOL score. Results: Forty-one participants were enrolled between April 2023 and October 2024. Twenty-one participants failed screening because no stones were seen, stones were too large or small, stone visibility was too deep or obstructed, or they declined to participate. Twenty participants with 31 stones received the research procedure with seven undergoing a single repeat procedure. Twenty-two of 31 stones (71%) met the primary effectiveness outcome of no fragment > 2 mm with 17 of 31 stones (55%) reported as stone free. Median stone volume reduction (interquartile range) was 100% (88%-100%). No participants returned unexpectedly for care related to the procedure. AEs were all Grade I by modified Clavien classification. WISQOL scores improved on 10 of 15 completed questionnaires. Conclusions: Small, asymptomatic renal stones were effectively and safely removed in awake participants in a clinic setting. © 2025 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2025 by American Urological Association Education and Research, Inc.KeywordsKidney stonesUltrasoundLithotripsy Author Information Jonathan D. Harper Department of Urology, University of Washington, Seattle, WA, USA More articles by this author Barbrina Dunmire Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author Jeff Thiel Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author Barbara H. Burke Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA More articles by this author Yak-Nam Wang Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author Stephanie Totten Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author John C. Kucewicz Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author Adam D. Maxwell Department of Urology, University of Washington, Seattle, WA, USA Current affiliation: Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA More articles by this author M. Kennedy Hall Department of Emergency Department, University of Washington School of Medicine, Seattle, WA, USA More articles by this author Arturo E. Holmes Department of Urology, University of Washington, Seattle, WA, USA Wellstar Medical Group, Hiram, GA More articles by this author Christina Popchoi Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA, USA More articles by this author James E. Lingeman Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA More articles by this author Alana C. Desai Department of Urology, University of Washington, Seattle, WA, USA More articles by this author Robert M. Sweet Department of Urology, University of Washington, Seattle, WA, USA More articles by this author Manjiri Dighe Department of Radiology, University of Washington, Seattle, WA, USA More articles by this author Branda J. Levchak Seattle Institute for Biomedical and Clinical Research, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA More articles by this author Claire C. Yang Department of Urology, University of Washington, Seattle, WA, USA Section of Urology, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA More articles by this author Michael R. Bailey Correspondence and reprints: Michael Bailey, Ph.D. Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 49th St. Seattle, WA, USA ([email protected]) +1 206-619-2035 More articles by this author Mathew D. Sorensen Department of Urology, University of Washington, Seattle, WA, USA Section of Urology, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA More articles by this author Expand All Advertisement PDF downloadLoading ...