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Asian Journal of Urology, 2018, 5(4): 256-263    doi: 10.1016/j.ajur.2018.08.006
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Indications and contraindications for shock wave lithotripsy and how to improve outcomes
Luke F. Reynolds,Tad Kroczak,Kenneth T. Pace()
Division of Urology, St. Michael's Hospital, Toronto, Canada
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Abstract: 

For over 35 years shock wave lithotripsy has proven to be an effective, safe and truly minimally invasive option for the treatment of nephrolithiasis. Various technical factors as well as patient selection can impact the success of the procedure. We used published work focusing on outcomes of shock wave lithotripsy, risk of complications, and strategies for improving stone fragmentation to create this review. Multiple patient and technical factors have been found to impact success of treatment. Skin to stone distance, stone density and composition, size and location of the stone within the urinary system all influence stone free rates. A slower rate with a gradual increasing voltage, precise targeting, proper coupling will improve stone fragmentation and decrease risk of complications. The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.

Key words:  Kidney calculi    Nephrolithiasis    Urolithiasis    Extracorporeal shockwave therapy    Lithotripsy
收稿日期:  2018-01-30      修回日期:  2018-05-24           出版日期:  2018-10-20      发布日期:  2018-11-19      整期出版日期:  2018-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2018, 5(4): 256-263.
Luke F. Reynolds,Tad Kroczak,Kenneth T. Pace. Indications and contraindications for shock wave lithotripsy and how to improve outcomes. Asian Journal of Urology, 2018, 5(4): 256-263.
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http://www.ajurology.com/CN/10.1016/j.ajur.2018.08.006  或          http://www.ajurology.com/CN/Y2018/V5/I4/256
Stone location >10 mm ≤10 mm
SWL URS SWL URS
Proximal 74 79 66.5 85
Mid 67 82.5 75 91
Distal 71 92 74 94
Table 1  Stone free rates (%) with single treatment of SWL and URS for ureteric stones [2].
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