Scales CD Jr. 2025: Editorial Comment.

Charles D Scales Jr.
J Urol. 2025 Oct;214(4):424-425. doi: 10.1097/JU.0000000000004647

Abstract

no abstract available

Comment Hans-Göran Tiselius

Although this Editorial Comment only is a very short note on the comparison between SWL and URS for removal of lower pole stones it raises some questions that need to be seriously considered. It is concluded that in the comparison of the procedures referred to, SWL was more commonly applied than recommended in AUA guidelines. Moreover, the importance of the surgeon war emphasized.
The bottom-line of the comment is that, in view of the rapid and extensive development of endoscopic methods, updated clinical trials are “desperately needed”. That is of course an interesting and logical reflection. However, highly important. with what shall modern URS be compared? The question might appear strange, but the truth is that whereas URS has gone through a remarkable technical and advanced development, SWL has developed technically in a different direction with the goal to cope with urologists’ desire to carry out pain-free treatments without need of anesthesia or use of analgesics. In other words which types of SWL devices should best be compared with top-modern URS/RIRS?

Hans-Göran Tiselius