Current State and Future Developments of Non-Invasive Treatment of Urinary Stones with Extracorporeal Shock-Wave Lithotripsy
Extracorporeal shock-wave lithotripsy (ESWL) has now been in clinical use for eight years and has replaced other treatment techniques for the majority of calculi located in the upper urinary tract. For the first time, it has provided a completely non-invasive method for the treatment of renal and ureteral stones. The current range of its indications includes approximately 70% of non-selected urinary stone patients. An additional 25% of patients with more complex stones in the upper urinary tract can receive treatment with the lithotripter when the method is combined with endourological procedures. More recent additions to the range of routine clinical applications with the original device, the Dornier kidney lithotripter (ESWLR) have been its use in management of common bile-duct stones in combination with endosurgical or radiological manipulations and, with a modified kidney lithotripter, the successful treatment of gallstones which has led to the development of a multi-purpose device for biliary and urinary stones. In February, 1980, ESWL was introduced for clinical use in the Department of Urology, University of Munich, as the first non-invasive method to treat patients suffering from upper urinary-tract stones. It took only a short time to prove the efficacy, safety, and reliability of the method which dramatically changed the management of patients with upper urinary-tract stones. In 1983, further distribution of the lithotripter began, first in West Germany, followed by the USA, Europe, and Asia in 1984 (Table 1).
KeywordsUreteral Stone Urinary Stone Urethral Stricture Ureteral Obstruction Staghorn Stone
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