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Extracorporeal shockwave lithotripsy for upper tract urolithiasis.
1Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, Ohio, USA.
Current Opinion in Urology
|January 1, 2014
Summary
Extracorporeal shockwave lithotripsy (SWL) remains a primary treatment for urolithiasis. Careful patient selection and technique are crucial for successful SWL outcomes, especially when considering alternative endoscopic procedures.
Area of Science:
- Urology
- Nephrology
Background:
- Extracorporeal shockwave lithotripsy (SWL) has been the standard for urolithiasis management for 30 years.
- Endoscopic techniques are emerging as alternatives, prompting research into SWL's role and optimization.
Purpose of the Study:
- To review current considerations for extracorporeal shockwave lithotripsy (SWL) in urolithiasis management.
- To explore factors influencing SWL outcomes and patient selection.
Main Methods:
- Review of recent studies on SWL utilization and outcomes.
- Analysis of factors impacting SWL success, including patient selection and technique.
Main Results:
- SWL utilization remains high despite increased use of endoscopic methods.
- Patient selection is critical; prior SWL failure can negatively affect outcomes of subsequent endoscopic procedures.
- Ultrasound localization, patient positioning, stone characteristics (size, location, attenuation, volume), and renal cysts influence SWL success.
Conclusions:
- Recent research emphasizes the importance of patient selection, SWL technique, and follow-up.
- New SWL technologies show promise but require further investigation.
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