الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Urolithiasis is one of the most common urologic problems which has a great impact on the economic burden of any medical system. It is associated with significant morbidities. Many lines of treatment were offered over last years, each is associated with advantages and disadvantages. SWL is one of these lines which has its special indications and advantages. With time, technical advances offers more verities and tries to reach the optimum results within several fields, specially the medical one.
However, SWL is one of the less invasive modalities of treatment of urolithiasis, it is affected by stone site, degree of obstruction, and BMI of the patient, and also the focusing size, intensity and frequency of the shock waves of the lithotripter affect the outcome.
Several studies had been issued to understand the factors affecting stone disintegration and stone free rate using many types of lithotripters like the electrohydraulic ,the electromagnetic and the piezoelectric lithotripters concerning the stone size, density, patient’s BMI, shockwaves intensity …etc. but, the effect of changing focus size by piezoelectric lithotripter on in vivo stones still not well understood.
The main purpose of this study was to evaluate both efficacy and safety of different focus sizes of the SWL in treatment of renal stones less than 2 cm using piezoelectric lithotripter.
This was a prospective double blind randomized study, conducted on patients attending Urology Department at Benha University Hospital suffering from 10 to 20 mm radio-opaque renal stones and seeking treatment by SWL. Patients were randomly allocated in two groups, F1 Group: 67 Patients managed by 2mm focus & F3 Group: 68 Patients managed by F3 focus.
The main result of the study revealed that:
The results showed that 86.6% of the patients experienced SFR when subjected to F1 focus and 86.8% of the patients experienced SFR when subjected to F3 focus.
No significant differences were observed between the studied groups regarding residual stones, stone free rate and the need for auxiliary intervention.
In (F1) group, there were more associated morbidities in term of pain and hematuria; which were much higher than the (F3) group
In both groups the renal markers used to assess the renal injury increased within 2 hours post SWL and significantly improved 72 hours post the SWL treatment.
In the both groups; there were no significant creatinine changes reported after the SWL in relation to the baseline level.
Based on our findings, large-scale, multi-centered, randomized, studies are needed to assess the effect of changing the different settings of the shockwaves intensity, frequency and comparing the different focus sizes to the other in conjunction with evaluation of their traumatic effect upon renal tissues.
One article from these thesis was published in the British journal of urology in 22 May 2023 https://doi.org/10.1111/bju.16083, titled the effect of piezoelectric shockwave lithotripsy with 2- and 8-mm focus sizes on stone disintegration and renal injury.
Two other abstracts were published in the world congress of Endourology and Uro-technology in San-Diego, California and one of these two abstracts, one abstract won the Olympus prize for the Best Basic Research during the World Congress of Endourology (WCET 2022) in San-Diego.
Another two abstracts were published in the SIU congress in Montreal, Canada in November 2022 and all are added below.