Alken P., 2017: Intracorporeal lithotripsy.
Alken P.
Department of Urology, University Clinic Mannheim, Theodor Kutzer Ufer 1-3, 68167, Mannheim, Germany.
Abstract
Since the introduction of ESWL, PNL and URS during the early 1980s the application rate of ESWL has declined while those of PNL and URS have increased. This is mainly due to the facts that instruments and techniques for Intracorporeal Lithotripsy (IL) have made a continuous progress. This review shows that today an array of options for IL within the entire urinary tract is available to treat stones in a perfect minimal invasive way. At the same time further improvements of IL are already visible.
Urolithiasis. 2017 Dec 4. doi: 10.1007/s00240-017-1017-7. [Epub ahead of print] Review.
Comments 1
This review article gives an excellent and comprehensive description of different devices for intracorporeal stone disintegration. Although the described technology does not relate to SWL, it contains important information inasmuch as invasive methods for stone disintegration significantly have reduced the use of SWL, the only non-invasive approach.
It is obvious; however, that also stone disintegration with intracorporeal lithotripters is associated with problems such as fragment size, risk of tissue damage and stone propulsion.
One point that needs to be emphasized is of course that in many situations with large stones, a “smash and go” procedure is applied. Thereby fragments are left in the kidney with no or very limited advantage of intracorporeal lithotripsy compared with SWL.