Abstract
Extracorporeal shock wave lithotripsy (SWL) remains the only noninvasive modality in lithotripsy and still contributes to more than half of all urinary stone treatments worldwide; however, success rates vary significantly because different equipment and protocols are used. An overview of shock wave generation methods for SWL and comments on some representative modern lithotripters are given in the first part of the chapter. Descriptions of few old lithotripter models were included due to their historical importance. Furthermore, some interesting shock wave sources that remained as experimental devices are mentioned. Recommendations to perform efficient SWL treatments are given in the second part of the chapter. Contraindications, treatment of pediatric and obese patients, the influence of the focal size, shock wave rate, shock wave coupling, stone size, composition, and location on treatment outcomes, as well as the convenience of voltage-stepping and the use of prophylactic shock waves are discussed. SWL for gallbladder, pancreatic common bile duct, and salivary gland stones was also included. Although SWL is a routine in urology and millions of treatments have been performed successfully, improvements to increase stone fragmentation efficiency and reduce tissue damage are still being sought. The final section of this chapter deals with a few developments that might be incorporated into commercial devices in the future.
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Loske, A.M. (2017). Shock Wave Lithotripsy. In: Medical and Biomedical Applications of Shock Waves. Shock Wave and High Pressure Phenomena. Springer, Cham. https://doi.org/10.1007/978-3-319-47570-7_5
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