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Thomas K, 2015: Evolution of extracorporeal shockwave lithotripsy (ESWL).

Thomas K
Clinical lead for Urology, Honorary Senior Lecturer Kings College London, UK

Abstract

No abstract available.

BJU Int. 2014 Nov;114(5):636. doi:10.1111/bju.12885.

 

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Hans-Göran Tiselius on Friday, 13 March 2015 09:31

In this editorial comment factors that have resulted in decreased utilization of SWL for stone removal both in the ureters and kidneys are discussed. The question of centralization and standardization in special endoscopy/SWL centres to achieve better results is raised. It is commented, however, that improvements in endoscopic technology together with patients’ reluctance to travel for non-invasive treatment speaks in favour of endoscopy.

The occurrence of residual fragments after SWL is a major factor that is considered a shortcoming of the non-invasive approach. It needs, however, to be mentioned; that for ureteral stones residual fragments after SWL is essentially not a problem. In terms of health economics and proper utilization of operating rooms for patients, that really need invasive surgery, SWL thus still is an appropriate alternative.

In view of the most variable results of SWL of ureteral as well as renal stones reported in the literature, improved treatment strategies, further developed lithotripters and increased expertise in SWL obviously are necessary.

In this editorial comment factors that have resulted in decreased utilization of SWL for stone removal both in the ureters and kidneys are discussed. The question of centralization and standardization in special endoscopy/SWL centres to achieve better results is raised. It is commented, however, that improvements in endoscopic technology together with patients’ reluctance to travel for non-invasive treatment speaks in favour of endoscopy. The occurrence of residual fragments after SWL is a major factor that is considered a shortcoming of the non-invasive approach. It needs, however, to be mentioned; that for ureteral stones residual fragments after SWL is essentially not a problem. In terms of health economics and proper utilization of operating rooms for patients, that really need invasive surgery, SWL thus still is an appropriate alternative. In view of the most variable results of SWL of ureteral as well as renal stones reported in the literature, improved treatment strategies, further developed lithotripters and increased expertise in SWL obviously are necessary.
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