[Current status and future developments in noninvasive treatment of urinary calculi with extracorporeal shockwave...

Being a highly effective and minimally invasive treatment modality, extracorporeal shock wave lithotriopsy (ESWL) has come to be the therapy of choice in more than 80% of urinary stones. Apart from pregnancy and untreated coagulopathy as contraindications, generally accepted limiting factors are a stone size of > 2.5 cm and the presence of anatomical draining barriers. In such cases endourological procedures are indicated from the outset. Modern urinary stone therapy requires both extracorporeal and intracorporeal procedures of lithotripsy as indispensable complementary techniques. Third-generation lithotriptors are characterized by a dual stone location system (ultrasound and X-ray) and painless treatment without any need for analgesia. The current rapid development of lithotriptors is mainly driven by economic aspects and market requirements like multipurpose or mobile applicability. The "ideal" lithotriptor enabling even more effective, safer, and more comfortable treatment has yet to be developed.