Extracorporeal shockwave lithotripsy in the management of urinary stones: New concepts and techniques to improve outcomes

doi:10.1016/j.ajur.2024.02.002

Asian Journal of Urology, 2024, 11 (2): 143-148 doi: 10.1016/j.ajur.2024.02.002

Reviews

Extracorporeal shockwave lithotripsy in the management of urinary stones: New concepts and techniques to improve outcomes

Pilar Bahilo-Mateu^a,Alberto Budia-Alba^a,b,*(

)

^aLithotripsy and Endourology Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
^bLithotripsy and Endourology Unit, Urology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

Abstract
Related Citation (15)

Download:

HTML

PDF (468KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical practice.

Methods: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been made.

Results: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are described.

Conclusion: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.

Key words： Lithotripsy Extracorporeal shockwave Stone disease Treatment Urinary stone

Received: 24 February 2023 Available online: 20 April 2024

Corresponding Authors: * Lithotripsy and Endourology Unit, La Fe University and Polytechnic Hospital, Valencia, Spain. E-mail address: budia_alb@gva.es (A. Budia-Alba).

	Service
	E-mail this article
	Add to citation manager
	E-mail Alert
	Articles by authors
	Pilar Bahilo-Mateu
	Alberto Budia-Alba

TRENDMD:

Cite this article:

Pilar Bahilo-Mateu,Alberto Budia-Alba. Extracorporeal shockwave lithotripsy in the management of urinary stones: New concepts and techniques to improve outcomes[J]. Asian Journal of Urology, 2024, 11(2): 143-148.

URL:

http://www.ajurology.com/EN/10.1016/j.ajur.2024.02.002 OR http://www.ajurology.com/EN/Y2024/V11/I2/143

[1]	Budía Alba A, Bahilo Mateu P, Ordaz Jurado G, López-Acón JD, Trassierra Villa M, Boronat Tormo F. [New strategies and protocols in SWL]. Arch Esp Urol 2017;70:113e23. [Article in Spanish].
[2]	Zeng G, Zhong W, Chaussy C, Tiselius HG, Xu C, Turney B, et al. International Alliance of Urolithiasis guideline on shockwave lithotripsy. Eur Urol Focus 2023; 9:513e23.
[3]	Skolarikos A, Neisius A, Petrik A, Somani B, Thomas K, Gambaro G, et al. Guidelines on urolithiasis in European Association of Urology guidelines 2022 edition. http://uroweb.org/guidelines/compilations-of-all-guidelines. [Accessed date January 10 2023].
[4]	Landau E, Shenfeld O, Pode E, Shapiro A, Meretyk S, Katz G, et al. Extracorporeal shock wave lithotripsy in prepuberal children: 22-year experience at a single institution with a single lithotripter. J Urol 2009; 182(Suppl. 4):1835e9. https://doi.org/10.1016/j.juro.2009.04.084.
[5]	Dretler SP. Stone fragilityda new therapeutic distinction. J Urol 1988; 139:1124e7. doi: 10.1016/s0022-5347(17)42801-1 pmid: 3361657
[6]	Chaussy C, Bergsdorf T. Extracorporeal shock wave lithotripsy for lower pole calculi smaller than one centimeter. Indian J Urol 2008; 139:1124e7.
[7]	El-Assmy A, Abou-El-Ghar ME, El-Nahas AR, Refaie HF, Sheir KZ. Multidetector computed tomography: role in determination of urinary stones composition and disintegration with extracorporeal shock wave lithotripsydan in vitro study. Urology 2011; 77:286e90. doi: 10.1016/j.urology.2010.05.021
[8]	Gupta NP, Ansari MS, Kesarvani P, Kapoor A, Mukhopadhyay S. Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int 2005; 95:1285e8. doi: 10.1111/j.1464-410X.2005.05520.x pmid: 15892818
[9]	Perks AE, Schuler TD, Lee J, Ghiculete D, Chung DG, D’A Honey RJ, et al. Stone attenuation and skin-to-stone distance on computed tomography predicts for stone fragmentation by shock wave lithotripsy. Urology 2008; 72:765e9. doi: 10.1016/j.urology.2008.05.046 pmid: 18674803
[10]	Park BH, Choi H, Kim JB, Chang YS. Analyzing the effect of distance from skin to stone by computed tomography scan on the extracorporeal shock wave lithotripsy stone-free rate of renal stones. Korean J Urol 2012; 53:40e3. doi: 10.4111/kju.2012.53.1.40
[11]	Hammad FT, Balakrishnan A. The effect of fat and nonfat components of the skin-to-stone distance on shockwave lithotripsy outcome. J Endourol 2010; 24:1825e9. doi: 10.1089/end.2009.0685 pmid: 20879860
[12]	Pishchalnikov YA, Neucks JS, VonDer Haar RJ, 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; 176:2706e10. doi: 10.1016/j.juro.2006.07.149 pmid: 17085200
[13]	Neucks J, Pishchalnilov Y, Zancanaro A, Neucks JS, Pishchalnikov YA, Zancanaro AJ, et al. Improved acoustic coupling for shock wave lithotripsy. Res Urol 2008; 36:61e6. doi: 10.1007/s00240-007-0128-y
[14]	Logarakis NF, Jewett MA, Luymes J, Honey RJ. Variation in clinical outcome following shockwave lithotripsy. J Urol 2000; 163:721e5. pmid: 10687964
[15]	Bohris C, Stief CG, Strittmatter F. Improvement of SWL efficacy: reduction of the respiration-induced kidney motion by using an abdominal compression plate. J Endourol 2016; 30:411e6. doi: 10.1089/end.2015.0681 pmid: 26558296
[16]	Mucksavage P, Mayer WA, Mandel JE, Ban Arsdalen KN. High-frequency jet ventilation is beneficial during shock wave lithotripsy utilizing a newer unit with a narrower focal zone. Can Urol Assoc J 2010; 4:333e5. doi: 10.5489/cuaj.908
[17]	Semins MJ, Matlaga BR. Strategies to optimize shock wave lithotripsy outcome: patient selection and treatment parameters. World J Nephrol 2015; 4:230e4. doi: 10.5527/wjn.v4.i2.230
[18]	Aboumarzouk OM, Hasan R, Tasleem A, Mariappan M, Hutton R, Fitzpatrick J, et al. Analgesia for patients undergoing shockwave lithotripsy for urinary stonesda systematic review and meta-analysis. Int Braz J Urol 2017; 43:394e406. doi: 10.1590/S1677-5538.IBJU.2016.0078 pmid: 28338301
[19]	Budia A, Caballer V, Vivas-Consuelo D. Comparison of extracorporeal shock wave lithotripsy versus ureteroscopy holmium laser lithotripsy in the management of ureteral stones: a costeffectiveness analysis [Internet] Med Surg Urol 2016; 5. http://www.omicsonline.org/open-access/comparison-ofextracorporeal-shock-wave-lithotripsy-versusureteroscopyholmium-laser-lithotripsy-in-themanagement-of-ureteralston-2168-9857-1000168.php?aidZ77614. [Accessed 10 January 2023].
[20]	Bahilo P, Caballer V, López-Acón JD, Budía A, Vivas-Consuelo D, Trassierra M, et al. MP54e 07 Comparison of extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery in the management of small moderated-sized renal stones: a costeffectiveness analysis. J Urol 2016;195(4S). https://doi.org/10.1016/j.juro.2016.02.577.
[21]	Ordaz Jurado DG, Budia Alba A, Bahilo Mateu P, Trassierra M, Lopez-Acon, Boronat F. Shockwave lithotripsy with music: less painful and more satisfactory treatment. Actas Urol Esp 2017; 41: 584e9. doi: S0210-4806(17)30044-X pmid: 28412009
[22]	Al-Dessoukey AA, Abdallah M, Moussa AS, Sayed O, Abdelbary AM, Abdallah R, et al. Ultraslow full-power shock wave lithotripsy versus slow power-ramping shock wave lithotripsy in stones with high attenuation value: a randomized comparative study. Int J Urol 2020; 27:165e70. doi: 10.1111/iju.14158 pmid: 31793084
[23]	López-Acón D, Budia A, Bahilo MP, Trassierra M, Conca-Baenas MA, Ordaz-Jurado G, et al. Analysis of the efficacy and safety of increasing the energy dose applied per session through increasing the number of shock waves in extracorporeal lithotripsy: a prospective and comparative study. J Endourol 2017;31:1289e94.
[24]	Connors BA, Evan AP, Handa RK, Blomgren PM, Johnson CD, Liu Z, et al. Using 300 pretreatment shock waves in a voltage ramping protocol can significantly reduce tissue injury during extracorporeal shock wave lithotripsy. J Endourol 2016; 30: 1004e8. doi: 10.1089/end.2016.0087 pmid: 27307070
[25]	Skuginna V, Nguyen DP, Seiler R, Kiss B, Thalmann GN, Roth B. Does stepwise voltage ramping protect the kidney from injury during extracorporeal shockwave lithotripsy? Results of a prospective randomized trial. Eur Urol 2016; 69:267e73. doi: 10.1016/j.eururo.2015.06.017 pmid: 26119561
[26]	Rassweiler JJ, Knoll T, K?hrmann KU, Rassweiler JJ, Knoll T, K?hrmann KU, et al. Shock wave technology and application: an update. Eur Urol 2011;59:784e96.
[27]	Chen TT, Samson PC, Sorensen MD, Bailey MR. Burst wave lithotripsy and acoustic manipulation of stones. Curr Opin Urol 2020; 30:149e56. doi: 10.1097/MOU.0000000000000727 pmid: 31905177