First experience with a modified Siemens Lithostar shock wave system.

A Siemens Lithostar shock wave system was modified and investigated clinically. The modified system yields increased focal pressure and energy density. The first clinical experience in renal calculi shows a significant reduction in shock wave numbers per treatment. Higher energy output enables better treatment results for difficult stones such as staghorn and infections calculi. Despite the higher energy output more than 90% of treatments could be performed without anesthesia or analgesia. No significant side effects could be detected. The service life of the modified shock wave system increased by a factor of two.