Burst wave lithotripsy: insights on effectiveness and safety

Area of Science:

• Urology
• Biomedical Engineering
• Medical Devices

Background:

• Conventional shock wave lithotripsy has limitations including variable efficacy, pain, and tissue injury.
• Burst wave lithotripsy (BWL) is a novel noninvasive approach for urinary stone management.

Purpose of the Study:

• To review experimental and early clinical evidence of BWL.
• To evaluate BWL as a noninvasive, anesthesia-sparing option for urinary stone management.

Main Methods:

• Review of experimental, preclinical, and first-in-human studies.
• Analysis of stone fragmentation efficiency, fragment size control, and patient tolerability.
• Evaluation of safety profiles, including in anticoagulated models.

Main Results:

• BWL achieves efficient stone fragmentation across various compositions with controllable fragment size via frequency modulation.
• Clinical studies report high stone comminution rates, favorable fragment profiles, and excellent tolerability in awake patients.
• Integration with ultrasonic propulsion enhances fragment clearance and stone-free outcomes; preclinical data show a favorable renal safety profile.

Conclusions:

• BWL is a promising complementary technology for selected renal and ureteral stones.
• It offers truly noninvasive, patient-centered care.
• Ongoing trials will define its role in treatment algorithms and optimal indications.