Indications and contraindications for shock wave lithotripsy and how to improve outcomes

doi:10.1016/j.ajur.2018.08.006

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(

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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

Received: 30 January 2018 Published: 19 November 2018

Corresponding Authors: T. Pace Kenneth E-mail: pacek@smh.ca

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F. Reynolds Luke,Kroczak Tad,T. Pace Kenneth. Indications and contraindications for shock wave lithotripsy and how to improve outcomes[J]. Asian Journal of Urology, 2018, 5(4): 256-263.

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http://www.ajurology.com/EN/10.1016/j.ajur.2018.08.006 OR http://www.ajurology.com/EN/Y2018/V5/I4/256

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