The Journal of Urology can also remove kidney stones and explode them

According to a new feasibility study published today in the Journal of Urology, a new technique that combines two ultrasound techniques may offer an option to remove kidney stones from the ureter with minimal pain and no anesthesia
.

During the procedure, doctors use a handheld transducer placed on the skin to direct the ultrasound to the stones
.
Ultrasound can then be used to move and reposition stones to facilitate their passage, a process known as ultrasonic propulsion, or breaking stones, a technique known as burst wave lithotripsy (BWL
).

Unlike shockwave lithotripsy (which is currently used as a standard procedure that requires sedation), the technique does not cause harm, said
lead author Dr.
M.
Kennedy Hall, an emergency physician at the University of Washington School of Medicine.
"It's almost painless, and it's crucial that you can do it while the patient is awake and doesn't need sedation
.
"

Hall added that the research team hopes that with this new technology, the process of moving or crushing stones can eventually be carried out
in the clinic or emergency room.

Stones in the ureter (from the kidneys to the bladder) can cause severe pain and are a common cause of emergency department visits
.
Most patients with ureteral stones are advised to wait to see if the stones will pass on
their own.
However, Hall noted that this observation period can last for weeks, with nearly a quarter of patients eventually needing surgery
.

One in 11 Americans will develop urinary stones
in their lifetime.
According to a study by the University of Wisconsin Medical Research on the same technology, this incidence appears to be increasing
.
Studies have shown that up to 50% of people with stones will relapse
within five years.

Hall and his colleagues evaluated the new technique to meet the need
to treat stones without surgery.

Hall said the purpose of the study was to test the feasibility
of using ultrasound propulsion or using BWL to break down stones in awake, unanesthetized patients.

Twenty-nine patients participated in the study
.
16 patients were advancing treatment alone, and 13 patients were treated with shockwave lithotripsis
.
In 19 patients, the stones moved
.
In both cases, stones move out of the ureter and into the bladder
.

Burst wave lithotripsy shattered stones in 7 cases
.
During the two-week follow-up, 18 (86%) of the 21 patients with stones located in the lower ureter, near the bladder, were discharged
.
Studies have shown that in this group of patients, the average time for stones to be removed is about 4 days
.

Studies have shown that when the stone moves out of the ureter, one of the patients feels "immediate relief.
"

Hall said the next step for the researchers will be to conduct clinical trials in a control group that receives neither BWL pulses nor ultrasonic propulsion, to assess the extent to which this new technique may promote the removal of
stones.

The development of the technology first began five years ago, when NASA funded a study to see if kidney stones could move or break down during long-distance spaceflights, such as missions to Mars, without anesthesia
.
The technology is so effective that NASA has downgraded kidney stones to a major problem
.

Hall said, "We now have a potential solution to
this problem.
"

The study, which began in 2018, was conducted
in patients at Harborview Medical Center, Montlake Medical Center at the University of Washington, and the Northwest Kidney Stone Center at the University of Washington Medical Center.
The study involved the Department of Emergency Medicine, Urology and Radiology at the University of Washington School of Medicine, and the University of Washington Applied Physics Laboratory
.

Other trials at the University of Washington School of Medicine looked at the breakdown of kidney stones
within the kidneys.
Hall said this is the first attempt to move the stone inside the ureter or separate
the stone with BWL.

Journal of Urology

10.
1097 / JU.
0000000000002864

Experimental research

The first group treated ureteral stones with ultrasonic propulsion and shockwave lithotripsy

7 - October - 2022

Conflicts of Interest: MB, BC, BD and MS have a consulting agreement and equity interest with Sonomtion, Inc.
, which obtained a commercial license
for the technology from the University of Washington.
RMS: American Urological Association, Elsevier Publishing (Campbell Urology
).
ISM: Bard BD, Perceus Inc
。 MD: Philips Medical Imaging, General Electric Healthcare
.