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[Extracorporeal shockwave lithotripsy for upper urinary tract stone].
E Lechevallier1, O Traxer, C Saussine
1Service d'urologie, hôpital La Conception, 147, boulevard Baille, 13005 Marseille, France. elechevallier@ap-hm.fr
Summary
Extracorporeal shockwave lithotripsy (ESWL) effectively fragments kidney stones using acoustic shockwaves. Optimal ESWL involves specific frequencies, power adjustments, and consideration of contraindications for successful stone clearance.
Area of Science:
- Urology
- Biomedical Engineering
Context:
- Extracorporeal shockwave lithotripsy (ESWL) is a non-invasive procedure for breaking kidney stones.
- Understanding ESWL's mechanisms and parameters is crucial for effective treatment.
Purpose:
- To outline the principles, optimal parameters, contraindications, and success rates of ESWL.
- To provide guidance on managing residual stone fragments after ESWL.
Summary:
- ESWL utilizes acoustic shockwaves to fragment stones via spallation and squeezing.
- Optimal fragmentation requires a 1Hz frequency and progressive power increase.
- Contraindications include pregnancy, obesity, and coagulation disorders; stone density >1000UH is a failure risk factor.
- Success rates are 60-80% for kidney stones and 80% for ureteral stones.
- Alpha-blockers may aid stone clearance; residual fragments <4mm require annual follow-up.
Impact:
- Informs clinical practice for optimizing ESWL procedures.
- Contributes to improved patient outcomes in stone management.
- Highlights factors influencing ESWL success and potential complications.
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