Skip to main content

What You Should Know About Extracorporeal Shock Wave Lithotripsy and How You Can Improve Your Performance

  • Chapter
  • First Online:
Urolithiasis

Abstract

Shock wave lithotripsy still remains the only noninvasive treatment modality for urolithiasis besides conservative stone management. Overall it has high efficacy, comfortable application without the need of general anesthesia, low rate of side effects, and high patient acceptance. To obtain the best results, careful attention has to be paid to choice of lithotripter, coupling issues, power and spacing of shocks, post-ESWL care, and case selection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chaussy C, Eisenberger F, Forssmann B. Extracorporeal shock wave lithotripsy (ESWL): a chronology. J Endourol. 2007;21(11):1249–53.

    Article  PubMed  CAS  Google Scholar 

  2. Chaussy C, Brendel W, Schmiedt E. Extracorporeally induced destruction of kidney stones by shock waves. Lancet. 1980;2(8207):1265–8.

    Article  PubMed  CAS  Google Scholar 

  3. Chaussy C, Schmiedt E, Jocham D, Brendel D, Forssmann B, Walther V. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol. 1982;127(3):417–20.

    PubMed  CAS  Google Scholar 

  4. Schmiedt E, Chaussy C. Extracorporeal shock-wave lithotripsy of kidney and ureteric stones. Urol Int. 1984;39(4):193–8.

    Article  PubMed  CAS  Google Scholar 

  5. Bergsdorf T, Chaussy C. New trends in shock wave application regarding technology and treatment strategy. In: Loske A, editor. New trends in shock wave application to medicine and biotechnology. Trivandrum: Research Signpost; 2009. p. 1–19.

    Google Scholar 

  6. Bergsdorf T, Thueroff S, Chaussy C. Extracorporeal shock wave lithotripsy. In: Chaussy C, Haupt G, Jocham D, Koehrmann KU, editors. Therapeutic energy applications in urology II. Stuttgart: Thieme; 2010. p. 8–16.

    Google Scholar 

  7. Rassweiler JJ, Knoll T, Köhrmann KU, et al. Shock wave technology and application: an update. Eur Urol. 2011;59(5):784–96.

    Article  PubMed  Google Scholar 

  8. Folberth W, Hassler D. Value of in-line and out-off-line ultrasound targeting in extracorporeal shock wave lithotripsy. Eur Urol. 1990;18(3):215–21.

    PubMed  CAS  Google Scholar 

  9. Pishchalnikov YA, Neucks JS, VonDerHaar RJ, et al. Air pockets trapped during routine coupling in dry head lithotripsy can significantly decrease the delivery of shock wave energy. J Urol. 2006;176(6Pt1):2706–10.

    Article  PubMed  Google Scholar 

  10. Jain A, Shah TK. Effect of air bubbles in the coupling medium on efficacy of extracorporeal shock wave lithotripsy. Eur Urol. 2007;51(6):1680–6.

    Article  PubMed  Google Scholar 

  11. Bergsdorf T, Chaussy C, Thueroff S. Energy coupling in extracorporeal shock wave lithotripsy – the impact of coupling quality on disintegration efficacy. J Endourol. 2008;22(Suppl1):A161.

    Google Scholar 

  12. Bergsdorf T, Chaussy C, Thueroff S. The significance of accurate shock wave coupling in extracorporeal shock wave lithotripsy. J Endourol. 2009;23:1042.

    Google Scholar 

  13. Rassweiler JJ, Grenacher G, Haupt S, et al. The management of caliceal calculi: consensus report. In: Chaussy C, Eisenberger F, Jocham D, Wilbert D, editors. High energy shock waves in medicine. Stuttgart: Thieme; 1997. p. 44–51.

    Google Scholar 

  14. Albala DM, Assimos DG, Clayman RV, et al. Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol. 2001;166(6):2072–80.

    Article  PubMed  CAS  Google Scholar 

  15. Lindqvist K, Holmberg G, Peeker R, et al. Extracorporeal shock wave lithotripsy or ureteroscopy as primary treatment for ureteric stones. A retrospective study comparing two different treatment strategies. Scand J Urol Nephrol. 2006;40(2):113–8.

    Article  PubMed  Google Scholar 

  16. Miller N, Lingeman JE. Management of kidney stones. BMJ. 2007;334:468–72.

    Article  PubMed  Google Scholar 

  17. Pryor JL, Jenkins AD. Use of double-pigtail stents in extracorporeal shock wave lithotripsy. J Urol. 1990;143(3):475–8.

    PubMed  CAS  Google Scholar 

  18. El-Assmy A, El-Nahas AR, Sheir KZ. Is pre-shock wave lithotripsy stenting necessary for ureteral stones with moderate or severe hydronephrosis? J Urol. 2006;176(5):2059–62.

    Article  PubMed  Google Scholar 

  19. Sampaio FJ, Aragao AH. Inferior pole collecting system anatomy: it’s probable role in extracorporeal shock wave lithotripsy. J Urol. 1992;147(2):322–4.

    PubMed  CAS  Google Scholar 

  20. Danuser H, Müller R, Descoeudres B, et al. Extracorporeal shock wave lithotripsy of lower calyx calculi: how much is treatment outcome influenced by the anatomy of the collecting system? Eur Urol. 2007;52:539–46.

    Article  PubMed  Google Scholar 

  21. Obek C, Onal B, Kantay K, et al. The efficacy of extracorporeal shock wave lithotripsy for isolated lower pole calculi compared with isolated middle and upper caliceal calculi. J Urol. 2001;166(6):2081–4.

    Article  PubMed  CAS  Google Scholar 

  22. Riedler I, Trummer H, Hebel P, et al. Outcome and safety of extracorporeal shock wave lithotripsy as first-line therapy of lower pole nephrolithiasis. Urol Int. 2003;71(4):350–4.

    Article  PubMed  Google Scholar 

  23. Robert M, Marotta M, Rakotomalala E, et al. Piezoelectric extracorporeal shock-wave lithotripsy of lower pole nephrolithiasis. Eur Urol. 1997;32(3):301–4.

    PubMed  CAS  Google Scholar 

  24. Pearle MS, Lingeman JE, Leveillee R, et al. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol. 2005;173(6):2005–9.

    Article  PubMed  Google Scholar 

  25. Glowacki LS, Beecroft ML, Cook RJ, et al. The natural history of asymptomatic urolithiasis. J Urol. 1992;147:319–21.

    PubMed  CAS  Google Scholar 

  26. Tiselius HG, Ackermann D, Alken P, et al. Guidelines on urolithiasis. Eur Urol. 2001;40:362–71.

    Article  PubMed  CAS  Google Scholar 

  27. Thueroff S, Chaussy C. Ureteral calculi. In situ ESWL treatment with booster technique. Urologe A. 1997;36(3):209–16.

    Article  Google Scholar 

  28. Tiselius HG. How efficient is extracorporeal shockwave lithotripsy with modern lithotripters for removal of ureteral stones? J Endourol. 2008;22(2):249–55.

    Article  PubMed  Google Scholar 

  29. Pareek G, Hedican SP, Lee FT, et al. Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology. 2005;66(5):9141–4.

    Article  Google Scholar 

  30. Munoz RD, Tirolien PP, Belhamou S, et al. Treatment of reno-ureteral lithiasis with ESWL in obese patients. Apropos of 150 patients. Arch Esp Urol. 2003;56(8):933–8.

    PubMed  Google Scholar 

  31. Mezentsev VA. Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients. Int Braz J Urol. 2005;31(2):105–10.

    Article  PubMed  CAS  Google Scholar 

  32. Sheir KZ, Madbouly K, Esobky E, et al. Extracorporeal shock wave lithotripsy in anomalous kidneys: 11 year experience with two second generation lithotripters. Urology. 2003;62(1):10–5.

    Article  PubMed  Google Scholar 

  33. Turna B, Raza A, Moussa S, et al. Management of calyceal diverticular stones with extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy: long term outcome. BJU Int. 2007;100(1):151–6.

    Article  PubMed  Google Scholar 

  34. Chaussy GC, Fuchs GJ. Current state and future developments of non-invasive treatment of human urinary stones with ESWL. J Urol. 1989;141:782.

    PubMed  CAS  Google Scholar 

  35. Ringden I, Tiselius HG. Composition and clinically determined hardness of urinary tract stones. Scand J Urol Nephrol. 2007;41(4):316–23.

    Article  PubMed  Google Scholar 

  36. Zarse CA, Hameed TA, Jackson ME, et al. CT visible internal stone structure, but not Hounsfield unit value, of calcium oxalate monohydrate (COM) calculi predicts lithotripsy fragility in vitro. Urol Res. 2007;35(4):201–6.

    Article  PubMed  Google Scholar 

  37. Gofrit ON, Pode D, Meretyk S, et al. Is the pediatric ureter as efficient as the adult ureter in transporting fragments following extracorporeal shock wave lithotripsy for renal calculi larger than 10 mm? J Urol. 2001;166(6):1862–4.

    PubMed  CAS  Google Scholar 

  38. Cormack JR, Hui R, Olive D, et al. Comparison of two ventilation techniques during general anesthesia for extracorporeal shock wave lithotripsy: high-frequency jet ventilation versus spontaneous ventilation with a laryngeal mask airway. Urology. 2007;70(1):7–10.

    Article  PubMed  Google Scholar 

  39. Honey RJ, Healy M, Yeung M, et al. The use of an abdominal compression belt to reduce stone movement during extracorporeal shock wave lithotripsy. J Urol. 1992;148(3):1034–5.

    PubMed  CAS  Google Scholar 

  40. Semins MJ, Trock BF, Matlaga BR. The effect of shock wave rate on the outcome of shock wave lithotripsy: a meta-analysis. J Urol. 2008;179(1):194–7.

    Article  PubMed  Google Scholar 

  41. Maloney ME, Marguet CG, Zhou Y, et al. Progressive increase of lithotripter output produce better in-vivo stone comminution. J Endourol. 2006;20(9):603–6.

    Article  PubMed  Google Scholar 

  42. Collado Serra A, Huguet Perez J, Monreal Garcia de Vicuna F. Renal hematoma as a complication of extracorporeal shock wave lithotripsy. Scand J Urol Nephrol. 1999;33(3):171–5.

    Article  PubMed  CAS  Google Scholar 

  43. Willis LR, Evan AP, Connors BA, et al. Preventing of lithotripsy-induced renal injury by pretreating kidneys with low-energy shock waves. Am Soc Nephrol. 2006;17(3):663–73.

    Article  Google Scholar 

  44. Delius M, Enders G, Xuan ZR, et al. Biological effects of shock waves: kidney damage by shock waves in dogs – dose dependence. Ultrasound Med Biol. 1988;14(2):117–22.

    Article  PubMed  CAS  Google Scholar 

  45. Evan AP, McAteer JA, Conners BA, et al. Renal injury in SWL is significantly reduced by slowing down the rate of shock wave delivery. BJU Int. 2007;100:624–7.

    Article  PubMed  Google Scholar 

  46. Pace KT, Tariq N, Dyer SJ, et al. Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol. 2001;166(6):2065–71.

    Article  PubMed  CAS  Google Scholar 

  47. Chiong E, Hwee ST, Kay LM, et al. Randomized controlled study of mechanical percussion, dieresis, and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy. Urology. 2005;65(6):1070–4.

    Article  PubMed  Google Scholar 

  48. Rassweiler JJ, Renner C, Chaussy C, et al. Treatment of renal stones by extracorporeal shockwave lithotripsy: an update. Eur Urol. 2001;39(2):187–99.

    Article  PubMed  CAS  Google Scholar 

  49. Osman MM, Alfano Y, Kamp S. 5-year-follow-up of patients with clinically insignificant residual fragments after extracorporeal shock wave lithotripsy. Eur Urol. 2005;47(6):860–4.

    Article  PubMed  Google Scholar 

  50. Losek RL, Mauro LS. Efficacy of tamsulosin with extracorporeal shock wave lithotripsy for passage of renal and ureteral calculi. Ann Pharmacother. 2008;42(5):692–7.

    Article  PubMed  CAS  Google Scholar 

  51. Soyguer T, Akbay A, Kuepeli S. Effect of potassium citrate therapy on stone recurrence and residual fragments after shockwave lithotripsy in lower caliceal calcium oxalate urolithiasis: a randomized controlled trial. J Endourol. 2002;16(3):149–52.

    Article  Google Scholar 

  52. Krambeck AE, Gettmann MT, Rohlinger AL, et al. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup. J Urol. 2006;175(5):1742–7.

    Article  PubMed  Google Scholar 

  53. Sato Y, Tanda H, Kato S, Ohnishi S, et al. Shock wave lithotripsy for renal stones is not associated with hypertension and diabetes mellitus. Urology. 2008;71(4):586–91.

    Article  PubMed  Google Scholar 

  54. Eassa WA, Sheir KZ, Gad HM, et al. Prospective study of the long-tem effects of shock wave lithotripsy on renal function and blood pressure. J Urol. 2008;179(3):964–8.

    Article  PubMed  Google Scholar 

  55. Strohmaier WL, Schmidt J, Lahme S, et al. Arterial blood pressure following different types of urinary stone therapy. Eur Urol. 2000;38(6):753–7.

    Article  PubMed  CAS  Google Scholar 

  56. Wendt-Nordahl G, Krombach P, Hannak D, et al. Prospective evaluation of acute endocrine pancreatic injury as collateral damage of shock-wave lithotripsy for upper urinary tract stones. BJU Int. 2007;100(6):1339–43.

    Article  PubMed  Google Scholar 

  57. Krambeck AE, LeRoy AJ, Patterson DE, Gettman MT. Long-term outcomes of percutaneous nephrolithotomy compared to shock wave lithotripsy and conservative management. J Urol. 2008;179(60):2233–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christian G. Chaussy M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag London

About this chapter

Cite this chapter

Chaussy, C.G., Tiselius, HG. (2012). What You Should Know About Extracorporeal Shock Wave Lithotripsy and How You Can Improve Your Performance. In: Talati, J., Tiselius, HG., Albala, D., YE, Z. (eds) Urolithiasis. Springer, London. https://doi.org/10.1007/978-1-4471-4387-1_47

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4387-1_47

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4383-3

  • Online ISBN: 978-1-4471-4387-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics