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[Extracorporeal lithotripsy and our future approach in lithiasis]
A Schmidt1, E Geist, E G Eisenberger
1Departamento de Urología, Katharinenhospital, Stuttgart, Alemania.
Archivos Espanoles De Urologia
|July 1, 1994
Summary
Extracorporeal shock wave lithotripsy (ESWL) remains an effective treatment for kidney stones, though current advancements prioritize cost over improved outcomes or reduced side effects. Its established indications and limitations are well-defined.
Area of Science:
- Urology
- Nephrology
- Medical Technology
Context:
- Extracorporeal shock wave lithotripsy (ESWL) is a widely accepted treatment for kidney stones.
- Recent ESWL developments focus on economic factors rather than efficacy or side effect reduction.
- Established indications and limitations for ESWL are well-documented.
Purpose:
- To evaluate the current status and future directions of ESWL in stone ablation.
- To compare ESWL with emerging endourological techniques.
- To identify specific clinical scenarios where ESWL remains a primary or limited option.
Summary:
- ESWL is considered optimal for certain calculi, with routine indications and limitations clearly defined.
- Limitations include silent caliceal calculi, diverticular calculi, and stones in specific renal anatomies.
- Endourology offers less invasive alternatives, but their application is often limited to symptomatic cases.
Impact:
- ESWL remains a valuable tool, particularly for specific stone burdens and patient conditions.
- Endourological advancements like laser lithotripsy and ureteroscopy are expanding treatment options for distal ureteral calculi.
- Future research may focus on optimizing ESWL cost-effectiveness and integrating it with newer technologies.