[New strategies and protocols in SWL.]

Area of Science:

• Urology
• Nephrology
• Medical Technology

Background:

• Urinary calculi (kidney stones) management requires effective and minimally invasive treatments.
• Extracorporeal lithotripsy (ECL) is an established therapeutic option for urolithiasis.
• Continuous research aims to optimize existing treatment modalities for better patient outcomes.

Purpose of the Study:

• To provide an update on novel treatment strategies in extracorporeal lithotripsy.
• To evaluate these strategies as a valid therapeutic alternative for urinary calculi management.
• To identify best practices and optimization techniques in modern lithotripsy.

Main Methods:

• A comprehensive literature search was conducted using terms like "best practices", "update", "optimization", and "practice pattern" in lithotripsy.
• Review focused on recent literature to identify emerging treatment strategies.
• Inclusion criteria limited the review to articles published in English or Spanish.

Main Results:

• Stepwise voltage ramping during ECL, with or without an initial pause, improves treatment effectiveness.
• Decreased shock wave delivery rates and an increased number of shock waves per session are identified as effective strategies.
• These optimized parameters demonstrate an improved effectiveness with an optimum safety profile.

Conclusions:

• Extracorporeal lithotripsy remains a highly effective and minimally invasive treatment for urolithiasis.
• New treatment strategies are being developed to further enhance ECL effectiveness.
• The focus is on increasing efficacy while maintaining or improving the current safety profile.