Limitations of extracorporeal shock wave lithotripsy.

Abstract:

PURPOSE OF REVIEW:Extracorporeal shock wave lithotripsy (ESWL) is the preferred modality for the treatment of renal and upper ureteric calculi. The present review focuses on the limitations of ESWL, where recent developments have tried to identify patients who are unlikely to succeed with ESWL and where improvements in shock wave delivery may increase successful stone fragmentation. RECENT FINDINGS:Evaluation of patients prior to ESWL is especially important, and the use of imaging in the decision process, with the use of computed tomography attenuation values and skin-to-stone distance, can help improve our ability to identify suitable patients for shock wave treatment. Continued research into the methods of shock wave delivery techniques and lithotripter designs will help achieve better stone fragmentation rates with reduced side effects. SUMMARY:The importance of traditional factors in predicting ESWL success, such as stone size, location, composition and renal anatomy, are well known. More recently, authors have created nomograms to predict stone-free outcome after ESWL. Others have used the information obtained from computed tomography to predict stone comminution. In addition, modifications in shock wave delivery by altering shock rate and voltage have been researched in an effort to improve shock wave efficacy.

journal_name

Curr Opin Urol

authors

Madaan S,Joyce AD

doi

10.1097/MOU.0b013e32802b70bc

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

109-13

issue

2

eissn

0963-0643

issn

1473-6586

pii

00042307-200703000-00007

journal_volume

17

pub_type

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