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Electrohydraulic Lithotripsy (EHL) is a medical procedure which uses targeted shockwaves to break up kidney stones and gallstones. [1] This form of extracorporeal lithotripsy is unique in that the shockwaves are produced by a vaporization bubble expanding and collapsing repeatedly, creating a pressure wave. [ 1 ]
Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, [1] bezoars [2] or gallstones, which may be done non-invasively. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( litho- + τρίψω [tripso]).
Relatively high-energy ultrasound can break up stony deposits, ablate tissue, accelerate the effect of drugs in a targeted area, assist in the measurement of the elastic properties of tissue, and sort cells or small particles for research. [4] [5] Calcium oxalate (a type of kidney stone) fragments collected after treatment with lithotripsy.
Some of the passed fragments of a 1-cm calcium oxalate stone that was smashed using lithotripsy. The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones [3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse.
Lithotomy differs from lithotripsy, where the stones are crushed either by a minimally invasive probe inserted through the exit canal, or by an acoustic pulse (extracorporeal shock wave lithotripsy), which is a non-invasive procedure. Because of these less invasive procedures, the use of lithotomy has decreased significantly in the modern era.
Laser lithotripsy (LL) has been evaluated against Extracorporeal Shock Wave lithotripsy (ESWL), finding both to be safe and effective. [3] [4] ESWL may be safer for small stones (<10 mm), but less effective for 10–20 mm stones. [3] A 2013 meta-analysis found LL can treat larger stones (> 2 cm) with good stone-free and complication rates. [5]
As with other forms of pulmonary edema, the hallmark of SIPE is a cough which may lead to frothy or blood-tinged sputum. Symptoms include: Shortness of breath out of proportion to effort being expended. [2] [7] Rapid, heavy or uneven breathing, or uncontrollable coughing. [10]
Airway clearance therapy is treatment that uses a number of airway clearance techniques to clear the respiratory airways of mucus and other secretions. [1] Several respiratory diseases cause the normal mucociliary clearance mechanism to become impaired resulting in a build-up of mucus which obstructs breathing, and also affects the cough reflex.