Extracorporeal shock wave lithotripsy today

Tailly, Geert G.

doi:10.4103/0970-1591.117283

Cited by 27 publications

(13 citation statements)

References 35 publications

(16 reference statements)

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“…The next steps in the SWL procedure are identification of the target and optimal positioning of the patient [ 1 , 3 , 92 ]. Fluoroscopy is most commonly used [ 14 ], but ultrasound might also be used. The latter technique is used for identification of the radiolucent uric acid stones as an alternative to contrast medium.…”

Section: Technical Aspects On How To Carry Out the Shockwave Procedurmentioning

confidence: 99%

How can and should we optimize extracorporeal shockwave lithotripsy?

Chaussy

Tiselius

2017

Urolithiasis

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It is well recognized that the popularity of extracorporeal shock wave lithotripsy (SWL), despite its non-invasive character, has decreased during recent years. This is partly explained by the technological achievements in endoscopy and urologists’ enthusiasm for such procedures. Another explanation is that many urologists have been insufficiently successful with SWL. The latter effect might to some extent be a result of the performance of the lithotripter used, but in too many cases, it is evident that the principles of how shock wave lithotripsy should be carried out are poorly applied. The purpose of this article is to emphasize some important aspects on how SWL best should be used. Based on decades of experience, it stands to reason that success with SWL does not come automatically and attention has to be paid to all details of this technique.

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Section: Technical Aspects On How To Carry Out the Shockwave Procedurmentioning

confidence: 99%

How can and should we optimize extracorporeal shockwave lithotripsy?

Chaussy

Tiselius

2017

Urolithiasis

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“…Symptomatic or clinically significant bleeding requiring blood replacement occurs in approximately 2 out of 1,000 treated patients. Similarly, a large multicentre study assessed the incidence of renal haematomas at 0.5 and 0.14 % following ESWL treatment of renal and ureteral stones respectively [ 4 , 9 – 11 , 13 – 16 ]. Retroperitoneal haemorrhage after ESWL may cause haemodynamic shock and occasionally be fatal [ 17 , 18 ].…”

Section: Minimally Invasive Treatment Of Urolithiasismentioning

confidence: 99%

Cross-sectional imaging of iatrogenic complications after extracorporeal and endourological treatment of urolithiasis

et al. 2014

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Extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) currently represent the mainstay treatment options for the vast majority of patients with urolithiasis, with limited contraindications and high success rates. However, minimally invasive extracorporeal and endourological treatments are associated with a non-negligible morbidity including occasional life-threatening occurrences. These complications represent a source of concern for urologists since they may result in prolonged hospitalisation, need for surgical, endoscopic or interventional treatment, long-term renal impairment, and sometimes even medical malpractice claims. Due to the increasing prevalence of urolithiasis and the large number of therapeutic procedures performed, in hospitals with active urologic practices radiologists are increasingly requested to investigate suspected post-procedural complications following ESWL, PCNL or ureteroscopic stone removal. Based upon our experience, this pictorial essay provides an overview of current extracorporeal and endourological treatment modalities for urolithiasis, including indications and possible complications according to the most recent guidelines from the European Association of Urology (EAU). Afterwards, we review the clinical features and cross-sectional imaging appearances of common and unusual complications with case examples, including steinstrasse, subcapsular, perirenal and suburothelial haemorrhages, severe urinary tract infections (such as pyeloureteritis, pyelonephritis, renal abscesses and pyonephrosis), ureteral injuries and delayed strictures.Teaching points• Extracorporeal lithotripsy, percutaneous nephrolitotomy and ureteroscopy allow treating urolithiasis.• Minimally invasive extracorporeal and endourological treatment have non-negligible morbidity.• Multidetector CT allows confident assessment of stone-free status and postprocedural complications.• Main complications include steinstrasse, bleeding, severe infections, ureteral injuries and strictures.• Imaging triage allows the choice among conservative, surgical, endoscopic or interventive treatment.

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“…Many medical centres are concerned about the adverse effects of ESWL on tissues [14] . Clinical and experimental studies have shown that this treatment might have severe, acute and chronic effects on the kidney and its peripheral tissues [15] , [16] , [17] .…”

Section: Discussionmentioning

confidence: 99%

Effects of previous unsuccessful extracorporeal shockwave lithotripsy treatment on the performance and outcome of percutaneous nephrolithotomy

Türk

Yoldaş

Süelözgen

et al. 2017

Arab Journal of Urology

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ObjectiveTo evaluate the effects of previous unsuccessful extracorporeal shockwave lithotripsy (ESWL) treatment on the performance and outcome of percutaneous nephrolithotomy (PCNL).Patients and methodsOf 1625 PCNL procedures performed in our clinic, 393 renal units with similar stone burden and number of accesses was included in the present study. We categorised the study patients into two groups according to whether they underwent ESWL within 1 year prior to PCNL or not. Accordingly, Group 1 comprised 143 (36.3%) ESWL-treated patients and Group 2 comprised 250 (63.7%) non-ESWL-treated patients.ResultsResidual stones were detected in 36 (25.1%) of the ESWL-treated patients (Group 1) and in 60 (24%) of non-ESWL-treated patients (Group 2). There were no statistically significant differences between the groups for length of hospital stay (LOS), nephrostomy tube removal time, and the presence of residual stones. When we evaluated the groups for both the preoperative and postoperative haemoglobin (Hb) drop and blood transfusion rate, manifest Hb declines and more transfusions were required in the ESWL-treated patients (both P = 0.01).ConclusionsIn our study, previous ESWL treatment had no influence on the PCNL stone-free rate, operation time, incidence of postoperative complications, and LOS, in patients with similar stone burdens. However, bleeding during PCNL was more prevalent in the ESWL-treated patients, so close attention should be paid to bleeding in patients who have been pretreated with ESWL.

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Extracorporeal shock wave lithotripsy today

Cited by 27 publications

References 35 publications

How can and should we optimize extracorporeal shockwave lithotripsy?

How can and should we optimize extracorporeal shockwave lithotripsy?

Cross-sectional imaging of iatrogenic complications after extracorporeal and endourological treatment of urolithiasis

Effects of previous unsuccessful extracorporeal shockwave lithotripsy treatment on the performance and outcome of percutaneous nephrolithotomy

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