Second-generation shock-wave lithotripters. Variations, indications, and efficacy in the treatment of ureteral...

Second-generation lithotripters offer significant advances in the technology and delivery of high-energy shock waves. The final position that ultrasonographically guided machines will earn in the spectrum of lithotripters can be determined only as more clinical series are reported. Nonetheless, their compromised ability to handle ureteral calculi casts a shadow on the acquisition of such instruments by facilities that cannot afford to own and operate both x-ray and sonographically guided lithotripters.