New Tip Design and Shock Wave Pattern of Electrohydraulic Probes for Endoureteral Lithotripsy

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Abstract
A new tip design of a 3.3F electrohydraulic probe for endoureteral lithotripsy was evaluated in comparison to a regular probe. The peak pressure, as well as the slope of the shock front, depend solely on the voltage. Increasing the capacity leads merely to broader pulses. A laser-like short high-pressure pulse has a greater impact on stone disintegration than a corresponding broader low-pressure pulse of the same energy. Using the regular probe, only positive pressures were obtained. Pressure distribution around the regular tip was approximately spherical, whereas the modified probe tip "beamed" the shock wave to a great extent. In addition, a negative-pressure half-cycle was added to the initial positive peak pressure, which resulted in a higher maximal pressure amplitude. The directed shock wave had a greater depth of penetration into a model stone. Thus, the ability of the new probe to destroy harder stones especially should be greater. The trauma to the ureter was reduced when touching the wall tangentially. No difference in the effect of the two probes was seen when placing the probe directly on the mucosa.