Extracorporeal shock wave lithotripsy: What is new?

Abstract

ObjectivesThirty years after its introduction, extracorporeal shockwave lithotripsy (ESWL) is still first-line treatment for more than half of all urinary tract stones, but machines and treatment strategies have significantly developed over time. In this review, we summarise the latest knowledge about the clinically important aspects of ESWL.MethodsWe searched PubMed to identify relevant reports and the latest European Association of Urology guidelines, and standard urological textbooks were consulted.ResultsNew technical developments include: Twin-head and tandem-pulse shock-wave generators; wide-focus, low-pressure systems; optimised coupling; and automated location and acoustic tracking systems. Indications have been refined, making possible the identification of patients in whom ESWL treatment is likely to fail. By lowering the shock-wave rate, improving coupling, applying abdominal compression, power ‘ramping’ and postoperative medical expulsion therapy, treatment protocols have been optimised.ConclusionsPromising new technical developments are under development, with the potential to increase the stone-free rate after ESWL. For optimal results, the refined indications need to be respected and optimised treatment protocols should be applied.

A prospective randomised double-blind placebo-controlled trial to assess the effect of diuretics on shockwave lithotripsy of calculi

“…Various attempts have been made in the past to enhance the effectiveness of SWL, which have become a part of the standard treatment protocol today. These include lower shockwave rate, power ramping, percussion inversion, and diuresis for lower calyceal calculi, and medical expulsion therapy using α-blockers [2] , [3] , [4] , [5] , [6] .…”

The effects of hydroalcoholic extracts of watermelon and Persian melon rind on kidney stone prevention in male Wistar rats: Alternative medicine and the role of physician and nurse

“…Obesity, inactivity, urinary incontinence, urinary tract infection, urethral stricture, taking certain medications, and increased concentration of calcium in the blood are also effective (11)(12)(13). chemotherapeutic drugs, supportive techniques (including higher consumption of fluids, and acidic or alkaline solvents) and surgical methods including, ureteral obstruction surgery, extracorporeal shockwave therapy, transurethral lithotripsy, percutaneous nephrolithotomy and open surgery are the common methods for treatment (14,15). The side effects of chemotherapeutic drugs for kidney stones include nausea, itching, weight loss, jaundice, anuria, joint pain, and muscle weakness (2,5,11,16).…”

Submandibular duct sialoliths of unusual sizes- two case reports

“…Approximately 80-90% of these occur in submandibular gland or its duct, 5-10% in parotid gland and remaining in sublingual gland and other minor salivary glands. [2][3][4] The common involvement of submandibular gland and duct is due to the tenacity of submandibular saliva, which because of its high mucin content adheres to any foreign particle. 1 The main etiological factors for stone formation are related to saliva retention and saliva composition: among patients with sialolithiasis, the salivary calcium concentration is higher compared to healthy individuals.…”