Hazards to bladder and intestinal tissues from intravesical underwater electrical discharges from a surgical electronic lithoclast.

Previous studies have shown that electronic lithoclast discharges produce effects resembling an underwater explosion. It was predicted that the shock wave produced by each discharge could damage nearby gas-containing gut through a mechanism known to be associated with underwater detonations. Effects associated with rapid oscillation of the vapour bubble produced could cause damage to the wall of the bladder. Investigation of lithoclast discharges in vivo on goat, and in vitro on sheep bladders demonstrated perforation of both. In vitro studies in the rabbit demonstrated the predicted greater susceptibility of air-filled gut over that filled with fluid. These hazards would be even greater in the ureter and caution in the use of electronic fragmentation of vesical and ureteric calculi is urged in the light of these findings.