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[Clinical experiences with extracorporeal shockwave lithotripsy]
1Urologische Universitätsklinik, Inselspital Bern.
Schweizerische Medizinische Wochenschrift
|July 1, 1989
Summary
Extracorporeal shock wave lithotripsy (ESWL) is a highly effective treatment for urinary stones, offering high success rates and low morbidity. While auxiliary measures and anesthesia are sometimes needed, ESWL is now a cornerstone of modern urolithiasis management.
Area of Science:
- Urology
- Nephrology
- Medical Technology
Context:
- Extracorporeal shock wave lithotripsy (ESWL) has become a standard treatment for urinary calculi.
- The Dornier HM-3 lithotriptor was utilized for all treatments.
- A large cohort of 2738 patients were analyzed.
Purpose:
- To report clinical experience and outcomes of ESWL for urinary tract stones.
- To evaluate the efficacy and safety of ESWL across different stone locations and sizes.
- To identify contraindications and necessary patient preparation for ESWL.
Summary:
- ESWL demonstrated high stone-free rates for pelvic (95%), ureteral (84-96%), and renal stones (>4 cm, 74%).
- Auxiliary measures were required in 34% of patients, primarily for drainage or stone localization.
- Severe complications were infrequent, including urosepticemia (0.3%) and rare cases requiring nephrectomy or associated with pre-existing conditions.
Impact:
- ESWL is a minimally invasive, low-morbidity procedure with high success rates, making it indispensable in modern urinary stone treatment.
- Understanding ESWL's efficacy and limitations guides clinical decision-making for urolithiasis.
- Contraindications include acute pyelonephritis, coagulation disorders, and pregnancy, with anesthesia typically required.