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Extracorporeal shock wave lithotripsy

G Zanetti1, M Seveso

  • 1IRCCS Ospedale Maggiore di Milano, Institute of Urology.

Archivio Italiano Di Urologia, Andrologia : Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica E Nefrologica
|September 1, 1996
PubMed
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Extracorporeal shock wave lithotripsy (SWL) is the preferred treatment for most kidney stones. While effective at fragmenting stones, success rates vary by size and location, and SWL does not significantly impact long-term stone recurrence.

Area of Science:

  • Urology
  • Nephrology
  • Medical Technology

Background:

  • Extracorporeal shock wave lithotripsy (SWL) has been clinically used since 1980.
  • Its indications have expanded, making it a primary treatment for ureterorenal lithiasis.
  • Anesthesia-free SWL has increased retreatment rates but generally achieves sufficient stone fragmentation.

Purpose of the Study:

  • To evaluate the effectiveness of extracorporeal SWL for ureterorenal lithiasis.
  • To analyze stone-free rates based on stone characteristics and treatment parameters.
  • To assess the impact of SWL on long-term stone recurrence.

Main Methods:

  • Review of clinical data on extracorporeal SWL applications.
  • Analysis of stone-free rates across different lithotripter types and stone sizes (<1 cm, 1-2 cm, 2-3 cm).

Related Experiment Videos

  • Evaluation of treatment outcomes for staghorn stones and stones in different caliceal locations.
  • Assessment of stone recurrence and fragment regrowth rates over time.

    • Main Results:

    • Stone-free rates vary significantly with lithotripter type and stone size, decreasing for larger stones.
    • Monotherapy SWL for staghorn stones shows variable success (31-55%) with high residual fragment rates.
    • Stone-free rates are higher for upper calyceal stones (75-84%) compared to lower calyceal stones (<60%).
    • Annual recurrence rates (4-10%) and total new stone rates (23.4-36%) are comparable to untreated stone formers.

    Conclusions:

    • Extracorporeal SWL is a widely adopted and effective treatment for ureterorenal lithiasis.
    • Treatment success is influenced by stone size, location, and lithotripter technology.
    • SWL does not appear to significantly alter the long-term risk of lithiasis recurrence.