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Lithotripsy literature database Reviewer's Choice

Katsimperis S. et al., 2026: From conventional imaging software to artificial intelligence: tools for stone volume assessment in urolithiasis. Α review by the EAU and YAU sections of endourology.

Katsimperis S, Tzelves L, Juliebø-Jones P, Tsaturyan A, Ventimiglia E, Perri D, Boeykens M, Jahrreiss V, Moretto S, Sahin MF, Olivero A, Nowak Ł, Pietropaolo A, Martinez BB, Somani B, Skolarikos A.
World J Urol. 2026 May 24;44(1):379. doi: 10.1007/s00345-026-06484-0

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Written by: Peter Alken
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Yu A. et al., 2026: Comparative Analysis Between Burst-Wave Lithotripsy vs Standard Ultrasound- Guided Extracorporeal Shock Wave Lithotripsy for 5-10 mm Ureteral Stones.

Yu A, Wu P.
Arch Esp Urol. 2026 Mar;79(2):298-305. doi: 10.56434/j.arch.esp.urol.20267902.36

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Written by: Peter Alken
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Çoban F. et al., 2026: Risk factors and a predictive model for steinstrasse formation after shock wave lithotripsy in pediatric urolithiasis.

Çoban F, Kutlu H, Akbaba KT, Deniz ME, Kalyenci B.
Urolithiasis. 2026 Apr 10;54(1):86. doi: 10.1007/s00240-026-01975-6

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Al-Terki AE. et al., 2026: . Development and Implementation of the Selection, Entry, Lithotripsy, Exit, and CT (SELECT) Mnemonic and Checklist: A Structured Approach to Urolithiasis Assessment and Management for Urology Trainees and Junior Urologists.

Al-Terki AE, Yaiesh S, Khan RN, Maqames S, Al-Shaiji TF, Al-Soudan Al-Anzi N.
Cureus. 2026 Jan 9;18(1):e101200. doi: 10.7759/cureus.101200

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Çitgez S. et al., 2026: Extracorporeal Shockwave Lithotripsy Still Alive for Pediatric Ureteral Stones ≤1.0 cm2.

Çitgez S, Kırlı EA, Demirbilek M, Irmak F, Dereköylü E, Önal B.
J Endourol. 2026 Feb;40(2):252-259. doi: 10.1177/08927790251372163. Epub 2026 Feb 16.

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Zang M. et al., 2026: New advances in efficacy prediction of extracorporeal shock wave lithotripsy in pediatrics: a narrative review.

Zang M, Dong Y, Wang X, Han C, Jia J.
Front Pediatr. 2026 Jan 21;13:1681384. doi: 10.3389/fped.2025.1681384

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Yang CC. et al., 2026: Relapse Following Ultrasonic Propulsion-Facilitated Clearance of Residual Kidney Stone Fragments Versus Observation.

Yang CC, Holt SK, Desai AC.
J Endourol. 2026 Feb;40(2):246-251. doi: 10.1177/08927790251394321

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Rahman ME. et al., 2025: Artificial Intelligence in Urolithiasis Imaging and Intervention: A Narrative Review of Current Applications, Barriers, and Future Directions.

Mohammad Ekhlasur Rahman, Mahabub Hassan, Kashif Waheed, Faisal Haque, Nazeer Ibraheem, Muhammad Rakib Hasan, Mohamed Mohamed
Cureus. 2025 Nov 24;17(11):e97716. doi: 10.7759/cureus.97716 FREE TEXT

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Mantica G. et al., 2025: "Second-look" extracorporeal shock wave lithotripsy after percutaneous nephrolithotomy.

Guglielmo Mantica, Rafaela Malinaric, Federica Balzarini, Carlo Terrone
Urologia. 2025 Nov 20:3915603251398250. doi: 10.1177/03915603251398250

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Ripa F. et al., 2025: Imaging during pediatric stone management and follow up.

Francesco Ripa, Edoardo Bonacina, Stefano Paolo Zanetti, Giorgio Mazzon, Simon Choong 
World J Urol. 2025 Oct 31;43(1):656. doi: 10.1007/s00345-025-06041-1

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Ficky et al., 2025: Artificial Intelligence in the Prediction of Stone-Free Status in Urinary Stone Disease Treated with Extracorporeal Shockwave Lithotripsy: A Systematic Review.

Ficky, Nur Rasyid, Widi Atmoko, Ponco Birowo
F1000Res. 2025 Mar 26;14:16. doi: 10.12688/f1000research.152346.2. FREE FULL TEXT

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MacLennan S. et al., 2025: Updated Systematic Review and Meta-analysis of Extracorporeal Shock Wave Lithotripsy, Flexible Ureterorenoscopy, and Percutaneous Nephrolithotomy for Lower Pole Renal Stones.

Steven MacLennan, Oliver Wiseman, Daron Smith, Kathryn Starr, Lorna Aucott, Rodolfo Hernández, Paul Manson, Ruth Thomas, Charles Terry Clark, Graeme MacLennan, Dawn McRae, Victoria Bell, Seonaidh Cotton, Zara Gall, Ben Turney, Sam McClinton
Eur Urol. 2025 Sep;88(3):231-239. doi: 10.1016/j.eururo.2025.01.020.  FREE ARTICLE

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Wiseman O. et al., 2025: Clinical and cost-effectiveness of percutaneous nephrolithotomy, flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole stones: the PUrE RCTs.

Oliver Wiseman, Daron Smith, Kath Starr, Lorna Aucott, Rodolfo Hernández, Ruth Thomas, Steven MacLennan, Charles Terry Clark, Graeme MacLennan, Dawn McRae, Victoria Bell, Seonaidh Cotton, Zara Gall, Ben Turney, Samuel McClinton
Health Technol Assess. 2025 Aug;29(40):1-186. doi: 10.3310/WFRE6844 FREE FULL TEXT

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Noble PA. 2025: Real-time Monitoring of Urinary Stone Status During Shockwave Lithotripsy.

Peter A Noble
Urology. 2025 Jul 24:S0090-4295(25)00717-4. doi: 10.1016/j.urology.2025.07.044

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Tasian GE. et al., 2025: Ureteroscopy vs Shockwave Lithotripsy to Remove Kidney Stones in Children and Adolescents: A Nonrandomized Clinical Trial.

Gregory E Tasian, David I Chu, Caleb P Nelson, W Robert DeFoor, Justin B Ziemba, Jing Huang, Xianqun Luan, Michael Kurtz, Christina B Ching, Pankaj Dangle, Anthony J Schaeffer, Renea Sturm, Wayland Wu, Christopher Bayne, Nicolas Fernandez, Michael E Chua, Romano DeMarco, Pamela Ellsworth, Brian Augelli, Jing Bi-Karchin, Rebecca D McCune, Seth Vatsky, Susan Back, Zi Wang, Hunter Beck, Anna Kurth, Laura Kurth, Annabelle Pleskoff, Christopher B Forrest, Jonathan S Ellison; PKIDS Care Improvement Network; Kyle Rove, Scott Sparks, Eric Nelson, Bruce Schlomer, Aaron Krill, Ching Man Carmen Tong, Abby Taylor, Puneeta Ramachandra, Andrew Stec, Pasquale Casale, Douglas Coplen, Nicolette Janzen, Krystal Bagley, Michelle R Denburg, Kimberley Dickinson, Rosemary Laberee, Matt Lorenzo, Antoine Selman-Fermin, Joana Dos Santos, Campbell Grant, Kate Kraft, Bhalaajee Meenakshi-Sundaram 
JAMA Netw Open. 2025 Aug 1;8(8):e2525789. doi: 10.1001/jamanetworkopen.2025.25789 FREE TEXT

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Demir M. et al., 2025: Evaluating shear wave elastography as a predictor of extracorporeal shock wave lithotripsy outcomes in children.

Mehmet Demir, İsmail Yağmur, Osman Dere, İbrahim Halil Albayrak, Abdulhakim Şengel
Urolithiasis. 2025 Jun 25;53(1):126. doi: 10.1007/s00240-025-01796-z

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Wiseman O. et al., 2025: The PUrE randomised controlled trial 1: Clinical and cost effectiveness of flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole stones of ≤10 mm.

Oliver Wiseman, Daron Smith, Kathryn Starr, Lorna Aucott, Rodolfo Hernández, Ruth Thomas, Steven MacLennan, Charles Terry Clark, Graeme MacLennan, Dawn McRae, Victoria Bell , Seonaidh Cotton, Zara Gall, Ben Turney, Sam McClinton 
Eur Urol. 2025 Apr 22:S0302-2838(25)00071-5. doi: 10.1016/j.eururo.2025.02.002 FREE ARTICLE

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Lozova E. et al., 2025: Stone density can predict the number of ESWL treatments needed in patients with pancreatic duct calculi.

Evgenija Lozova, Mia Rainio, Marianne Udd, Outi Lindström, Taija Korpela, Antti Kuuliala, Arto Mikkola, Leena Kylänpää
Scand J Gastroenterol. 2025 Apr;60(4):386-393. doi: 10.1080/00365521.2025.2475084

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Çavdar OF. et al., 2025: Residual stone fragments: systematic review of definitions, diagnostic standards.

O F Çavdar, A Aydin, T Tokas, A Tozsin, N Gadzhiev, M G Sönmez, R Tekeli, G Ortner, P Kallidonis, B Akgül, T Knoll, G Bianchi, J Rassweiler, K Ahmed, S Guven
World J Urol. 2025 Mar 28;43(1):194. doi: 10.1007/s00345-025-05572-x FREE PMC ARTICLE

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Harper JD. et al., 2025: Facilitated clearance of small, asymptomatic, renal stones with burst wave lithotripsy and ultrasonic propulsion.

Jonathan D Harper, Barbrina Dunmire, Jeff Thiel, Barbara H Burke, Yak-Nam Wang, Stephanie Totten, John C Kucewicz, Adam D Maxwell, M Kennedy Hall, Arturo E Holmes, Christina Popchoi, James E Lingeman, Alana C Desai, Robert M Sweet, Manjiri Dighe, Branda J Levchak, Claire C Yang, Michael R Bailey, Mathew D Sorensen
J Urol. 2025 Mar 17:101097JU0000000000004533. doi: 10.1097/JU.0000000000004533

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Mahkooyeh SA. et al., 2024: The effect of education on pre-operative anxiety in patients undergoing extracorporeal shock wave lithotripsy.

Saeideh Azizi Mahkooyeh, Masoomeh Zakerimoghadam, Shima Haghani, Mojdeh Navidhamidi 
J 4 Educ Health Promot. 2024 Nov 29;13:445. doi: 10.4103/jehp.jehp_1111_23 FREE PMC ARTICLE

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Xu H. et al., 2024: The Association Between Stone Heterogenicity and the Success of Shock Wave Lithotripsy for High Density Upper Urinary Tract Stones: A Muti-Center Prospective Cohort.

Hanfeng Xu, Junlong Liu, Zheming Li, Chengshan Ge, Hongqiang Guo, Shiyu Song, Zhenhua Li, Song Bai 
Urology. 2024 Nov 20:S0090-4295(24)00970-1. doi: 10.1016/j.urology.2024.10.069

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Jiaxin Li. et al., 2024: Predictive value of machine learning model based on CT values for urinary tract infection stones

Jiaxin Li, Yao Du, Gaoming Huang, Chiyu Zhang, Zhenfeng Ye, Jinghui Zhong, Xiaoqing Xi, Yawei Huang 
iScience. 2024 Oct 23;27(12):110843. doi: 10.1016/j.isci.2024.110843 FREE TEXT

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Sorensen MD et al., 2024: Randomized Controlled Trial of Ultrasonic Propulsion-Facilitated Clearance of Residual Kidney Stone Fragments vs Observation.

Mathew D Sorensen, Barbrina Dunmire, Jeff Thiel, Bryan W Cunitz, Barbara H Burke, Branda J Levchak, Christina Popchoi, Arturo E Holmes, John C Kucewicz, M Kennedy Hall, Manjiri Dighe, Jessica C Dai, Fionnuala C Cormack, Ziyue Liu, Michael R Bailey, Michael P Porter, Jonathan D Harper 
J Urol. 2024 Dec;212(6):811-820. doi: 10.1097/JU.0000000000004186

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Ben H Chew et al., 2024: Break Wave Lithotripsy for Urolithiasis: Results of the First-in-Human International Multi-Institutional Clinical Trial

Ben H Chew, Jonathan D Harper, Roger L Sur, Thomas Chi, Shubha De, Anne R Buckley, Ryan F Paterson, Victor K F Wong, Connor M Forbes, M Kennedy Hall, Ross Kessler, Seth K Bechis, Jason R Woo, Ralph C Wang, David B Bayne, Derek Bochinski, Trevor D Schuler, Tim A Wollin, Rahim Samji, Mathew D Sorensen 
J Urol. 2024 Oct;212(4):580-589. doi: 10.1097/JU.0000000000004091

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Michaël Mel Henderickx et al., 2024: Heavy as a rock or light as dust: a comparison between the perceived workload for extracorporeal shockwave lithotripsy, ureterorenoscopy and percutaneous nephrolithotomy

Michaël Mel Henderickx, Nora Hendriks, A Carolien Bouma-Houwert, Joyce Baard, Guido M Kamphuis, Hugo W Schuil, Harrie P Beerlage, D Martijn de Bruin 
Cent European J Urol. 2024;77(1):129-135. doi: 10.5173/ceju.2023.214  FREE PMC ARTICLE

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Patrick Juliebø-Jones et al., 2024: Patient experiences and perceptions of kidney stone surgery: what lessons can be learned from TikTok?

Patrick Juliebø-Jones, Lazaros Tzelves, Christian Beisland, Ingunn Roth, Bhaskar K Somani
Front Surg. 2024 Mar 20:11:1374851. doi: 10.3389/fsurg.2024.1374851

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Chi-Fai Ng et al., 2024: Effect of Focal Zone Size on Treatment Outcomes and Renal Injury Following Extracorporeal Shockwave Lithotripsy of Renal Calculi: A Prospective Randomized Study

Chi-Fai Ng , Chi Hang Yee, Jeremy Y C Teoh, Peter K F Chiu, Angel W Y Kong, Becky S Y Lau, Steven C H Leung, Ka Tak Wong, Winnie C W Chu
J Endourol. 2024 May;38(5):505-512. doi: 10.1089/end.2023.0662

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Mohamed Samir et al., 2024: Can shear wave elastography predict the success of shock wave lithotripsy used in renal stones treatment? A prospective study

Mohamed Samir, Abdelrahim Galaleldine, Tarek El-Zayat, Noha Diaa Eldin, Mahmoud A Mahmoud, Diaa Mostafa 
World J Urol. 2024 Mar 15;42(1):160. doi: 10.1007/s00345-024-04855-z FREE FULL TEXT

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Owen K. et al., 2023: Role of Noncontrast Computed Tomography Parameters in Predicting the Outcome of Extracorporeal Shock Wave Lithotripsy for Upper Urinary Stones Cases: A Meta-analysis.

Owen K, Joe W, Ivander A, Palgunadi IN, Adhyatma KP.
Acad Radiol. 2023 Nov 18:S1076-6332(23)00556-1. doi: 10.1016/j.acra.2023.10.021

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Soleimani MJ. et al., 2023: Investigating ESWL success rate in the treatment of renal and ureteral stones in children

Soleimani MJ, Shahrokh H, Soraki VV, Fakhar V, Ghaed MA, Narouie B.
Urologia. 2023 Mar 18:3915603231162663. doi: 10.1177/03915603231162663

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Hou J. et al., 2023: Efficacy and safety of the surgical treatments for lower calyceal stones: A systematic review and network meta-analysis

Jun Hou, Feihong Xu, Huifang Du, Jingxuan Liu, Ning Li
Int J Surg. 2023 Mar 4. doi: 10.1097/JS9.0000000000000062

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Hall MK. et al., 2022: First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral Stones.

Hall MK, Thiel J, Dunmire B, Samson PC, Kessler R, Sunaryo P, Sweet RM, Metzler IS, Chang HC, Gunn M, Dighe M, Anderson L, Popchoi C, Managuli R, Cunitz BW, Burke BH, Ding L, Gutierrez B, Liu Z, Sorensen MD, Wessells H, Bailey MR, Harper JD.
J Urol. 2022 Nov;208(5):1075-1082. doi: 10.1097/JU.0000000000002864

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Chou HW. et al., 2022: Experimental Observation of Isolative Efficacy of a Solid Coupling Medium in Extracorporeal Shock Wave Lithotripsy-Implications to Nosocomial Infection Prevention.

Chou HW, Huang CL, Lin YC, Lin YE, Chen WC.
Pathogens. 2022 Sep 27;11(10):1103. doi: 10.3390/pathogens11101103 FREE ARTICLE

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Tiwari AK. et al., 2022: Emergency extracorporeal shock wave lithotripsy: A study on feasibility and efficacy in stone clearance and reducing morbidity in ureteric and renal stones with colic.

Tiwari AK, Sarkar D, Pal DK.
Urologia. 2022 Dec 14:3915603221140444. doi: 10.1177/03915603221140444

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Motolova M. et al., 2022: Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy.

Motolova M, Kral M.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022 Jun 27. doi: 10.5507/bp.2022.029

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Bosio A. et al., 2022: Flexible Ureterorenoscopy Versus Shockwave Lithotripsy for Kidney Stones ≤2 cm: A Randomized Controlled Trial.

Bosio A, Alessandria E, Dalmasso E, Agosti S, Vitiello F, Vercelli E, Bisconti A, Gontero P.
Eur Urol Focus. 2022 Apr 21:S2405-4569(22)00081-5. doi: 10.1016/j.euf.2022.04.004

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Young MJ. et al., 2022: Acute extracorporeal shockwave lithotripsy (ESWL) for ureteric stones - 7-years' experience from a busy district general hospital.

Young MJ, Pang KH, Elmussarah M, Hughes PF, Browning AJ, Symons SJ.
BJU Int. 2022 Jun 10. doi: 10.1111/bju.15820

 

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Choi MJ. et al., 2022: First report on the persist time of the free radical produced by shock wave pulses employed in clinical ESWL.

Choi MJ, Lee JY, Park EJ.
Ultrason Sonochem. 2022 Feb;83:105927. doi: 10.1016/j.ultsonch.2022.105927 FREE ARTICLE

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Yuan F. et al., 2021: Low-intensity extracorporeal shockwave therapy for erectile dysfunction: an overview of systematic reviews.

Yuan F, Wang Y, Ma Z, Jing M, You Y, Yu X, Chang D, Zhang P.
Transl Androl Urol. 2021 Sep;10(9):3684-3696. doi: 10.21037/tau-21-730 FREE ARTICLE

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Abstract not available: Juliebø-Jones P. et al., 2021: The art of shockwave lithotripsy is an endangered species and is worth saving: the perspective of the European Association of Urology (EAU) Young Academic Urology (YAU) Urolithiasis group

Juliebø-Jones P, Keller EX, Tailly T, Æsøy MS, Esperto F, Mykoniatis I, de Coninck V, Pietropaolo A.
World J Urol. 2021 Nov 17:1-2. doi: 10.1007/s00345-021-03883-3 FREE ARTICLE

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Wymer KM. et al., 2021: Cost-effectiveness of Retrograde Intrarenal Surgery, Standard and Mini Percutaneous Nephrolithotomy, and Shock Wave Lithotripsy for the Management of 1-2cm Renal Stones.

Wymer KM, Sharma V, Juvet T, Klett DE, Borah BJ, Koo K, Rivera M, Agarwal D, Humphreys MR, Potretzke AM.
Urology. 2021 Jul 15:S0090-4295(21)00640-3. doi: 10.1016/j.urology.2021.06.030

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Herout R. et al., 2021: Contemporary treatment trends for upper urinary tract stones in a total population analysis in Germany from 2006 to 2019: will shock wave lithotripsy become extinct?

Herout R, Baunacke M, Groeben C, Aksoy C, Volkmer B, Schmidt M, Eisenmenger N, Koch R, Oehlschläger S, Thomas C, Huber J.
World J Urol. 2021 Aug 28. doi: 10.1007/s00345-021-03818-y

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Rassweiler J. et al., 2021: In-vitro comparison of two electromagnetic shock-wave generators: low-pressure-wide focus versus high-pressure small focus - the impact on initial stone fragmentation and final stone comminution.

Rassweiler J, Rieker P, Pecha R, Dressel M, Rassweiler-Seyfried MC.
J Endourol. 2021 Jul 27. doi: 10.1089/end.2021.0416

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Wang CS. et al., 2021: Newly designed solid coupling medium for reducing trapped air pockets during extracorporeal shock wave lithotripsy_ a phantom study

Wang CS, Li CC, Wu WJ, Liou WC, Lin YE, Chen WC.
BMC Urol. 2021 May 14;21(1):79. doi: 10.1186/s12894-021-00847-y FREE ARTICLE

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Dasgupta R. et al., 2021: Shockwave Lithotripsy Versus Ureteroscopic Treatment as Therapeutic Interventions for Stones of the Ureter (TISU): A Multicentre Randomised Controlled Non-inferiority Trial

Dasgupta R, Cameron S, Aucott L, MacLennan G, Thomas RE, N'Dow J, Norrie J, Anson K, Keeley FX Jr, MacLennan SJ, Starr K, McClinton S.
Eur Urol. 2021 Mar 30:S0302-2838(21)00171-8. doi: 10.1016/j.eururo.2021.02.044

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Michel KF. et al., 2021: Emergency department and hospital revisits after ambulatory surgery for kidney stones: an analysis of the Healthcare Cost and Utilization Project

Michel KF, Patel HD, Ziemba JB.
Urolithiasis. 2021 Feb 17. doi: 10.1007/s00240-021-01252-8

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Romeu G. et al., 2021: Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost-utility analysis in the Spanish clinical setting

Romeu G, Marzullo-Zucchet LJ, Díaz J, Villarroya S, Budía A, Ordaz DG, Caballer V, Vivas D.
World J Urol. 2021 Feb 22. doi: 10.1007/s00345-021-03620-w

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Falahatkar S. et al., 2021: The effects of pregabalin, solifenacin and their combination therapy on ureteral double-J stent-related symptoms: A randomized controlled clinical trial

Falahatkar S, Beigzadeh M, Mokhtari G, Esmaeili S, Kazemnezhad E, Amin A, Herfeh NR, Falahatkar R.
Int Braz J Urol. 2021 May-Jun;47(3):596-609. doi: 10.1590/S1677-5538.IBJU.2020.0848 FREE ARTICLE

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Gul A. et al., 2020: Intracutaneous sterile water injection for pain relief during extracorporeal shock wave lithotripsy: comparison with diclofenac sodium

Gul A, Gul M.
Urolithiasis. 2020 Apr;48(2):103-108. doi: 10.1007/s00240-019-01147-9. Epub 2019 Jul 5.

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Friedlander DF. et al., 2020: Real-world comparative effectiveness of shockwave lithotripsy versus ureterorenoscopy for the treatment of urinary stones

Friedlander DF, Brant A, McClure TD, Del Pizzo J, Nowels MA, Trinh QD, Sedrakyan A, Chughtai B.
World J Urol. 2020 Sep 9. doi: 10.1007/s00345-020-03430-6

Abstract

Purpose: To identify clinical and non-clinical predictors of treatment failure and perioperative complications following ureterorenoscopy versus shockwave lithotripsy.

Methods: The New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) database was used to identify 226,331 patients who underwent index ureteroscopy or shockwave lithotripsy for renal stones from 2000 to 2016. Propensity-matched generalized linear-mixed modeling was utilized to compare failure and complication rates between the two procedure groups.

Results: 219,383 individuals meeting inclusion criteria who underwent either ureterorenoscopy (n = 124,342) or shockwave lithotripsy (n = 95,041) in New York State between 2000 and 2016 were included in our analysis. After propensity score matching, patients undergoing shockwave lithotripsy were found to have decreased odds of experiencing any type of 30-day complication (P < 0.001 for all) but increased odds of treatment failure at both 90 (OR 1.70, 95% CI 1.64-1.77) and 180 (OR 1.83, 95% CI 1.76-1.89) days (P < 0.001 for both).

Conclusion: Patients undergoing shockwave lithotripsy experienced significantly higher odds of treatment failure, although this undesirable outcome appears to be partially offset by lower 30-day complication rates.

Comment Peter Alken

This publication offers a refreshingly unbiased view on the two most frequent urological procedures. One feels a relief reading it compared to prospective randomized studies.
An idea, also formulated in the present paper, is getting popular: “Increasing emphasis on outcome measures that more accurately characterize the patient experience and the value of that experience draws into question the utility of past literature using traditional outcome measures, such as stone-free rate.”
There is additional interesting information on driving forces: “… a post-operative emergency department visit … may add as much as $6000 in episode based costs“ and “patients undergoing URS versus SWL were more frequently privately insured. To our knowledge, our paper is the first to identify payer status as a potential predictor of treatment modality for urinary stone disease.”
This reminds me of a paper by Wang et al. (1) which you find in this SWL literature database. I reviewed it 8 years ago. The authors looked at URS and ESWL treatments performed on ~ 1000 children in the Pediatric Health Information System (PISH) database. This is an US national database from 42 freestanding children’s hospitals in the US. One conclusion was: “Treatment choice depends significantly on the hospital at which a patient undergoes treatment” In other words, it was not the stone but the hospital door the parents opened that influenced the kind of therapy the child would get.

DJ-stent removal is of course not included in the evaluated data but will add to cost and patients discomfort

1. Wang HH, Huang L, Routh JC, Nelson CP. Shock wave lithotripsy vs ureteroscopy: variation in surgical management of kidney stones at freestanding children's hospitals. J Urol. 2012 Apr;187(4):1402-7. doi: 10.1016/j.juro.2011.12.010.


Peter Alken

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Harper JD. et al., 2020: First In-Human Burst Wave Lithotripsy (BWL) for Kidney Stone Comminution: Initial 2 case studies

Harper JD, Metzler I, Hall MK, Chen TT, Maxwell AD, Cunitz BW, Dunmire B, Thiel J, Williams JC Jr, Bailey MR, Sorensen MDJ.
J Endourol. 2020 Sep 17. doi: 10.1089/end.2020.0725

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Hirsch B. et al., 2020: Outcome groups and a practical tool to predict success of shock wave lithotripsy in daily clinical routine

Hirsch B, Abt D, Güsewell S, Langenauer J, Betschart P, Pratsinis M, Vetterlein MW, Schmid HP, Wildermuth S, Zumstein V.
World J Urol. 2020 May 20. doi: 10.1007/s00345-020-03253-5

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Ramesh S. et al., 2020: In Vitro Evaluation of Urinary Stone Comminution with a Clinical Burst Wave Lithotripsy System

Ramesh S, Chen TT, Maxwell AD, Cunitz BW, Dunmire B, Thiel J, Williams JC, Gardner A, Liu Z, Metzler I, Harper JD, Sorensen MD, Bailey MR.
J Endourol. 2020 Mar 20. doi: 10.1089/end.2019.0873

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Hegazy M. et al., 2020: The alternating bidirectional versus the standard approach during shock wave lithotripsy for upper lumbar ureteric stones: a randomized controlled trial

Hegazy M, El-Assmy A, Ali-El-Dein B, Sheir KZ.
World J Urol. 2020 Mar 23. doi: 10.1007/s00345-020-03148-5. [Epub ahead of print].

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Han CS et al., 2019: Dual-frequency setting for urinary stone fragmentation during shock wave lithotripsy: an in vitro study

Han CS, Vetter JM, Endicott R, Chevinsky M, Zafar A, Venkatesh R.
Urolithiasis. 2019 Oct 17. doi: 10.1007/s00240-019-01162-w. [Epub ahead of print]

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Marchetti KA. et al., 2019: Extracorporeal shock wave lithotripsy versus ureteroscopy for management of pediatric nephrolithiasis in upper urinary tract stones: multi-institutional outcomes of efficacy and morbidity

Marchetti KA, Lee T, Raja N, Corona L, Kraft KH, Wan J, Ellison JS.
J Pediatr Urol. 2019 Jun 21. pii: S1477-5131(19)30193-7. doi: 10.1016/j.jpurol.2019.06.006. [Epub ahead of print]

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Maxwell AD. et al., 2019: Evaluation of Renal Stone Comminution and Injury by Burst Wave Lithotripsy in a Pig Model

Maxwell AD, Wang YN, Kreider W, Cunitz BW, Starr F, Lee D, Nazari Y, Williams JC Jr, Bailey MR, Sorensen MD.

DOI: 10.1089/end.2018.0886

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Chi-Fai N. et al., 2019: Effect of stepwise voltage escalation on treatment outcomes following extracorporeal shockwave lithotripsy of renal calculi: a prospective randomized study

Chi-Fai N, Yee CH, Teoh JY, Lau B, Leung SC, Wong CY, Tak WK, Chu WC, Yuen J.
J Urol. 2019 May 21:101097JU0000000000000344. doi: 10.1097/JU.0000000000000344. [Epub ahead of print]

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Ichiyanagi O. et al., 2019: Reinforcement of the Triple D score with simple addition of the intrarenal location for the prediction of the stone-free rate after shockwave lithotripsy for renal stones 10-20 mm in diameter

Ichiyanagi O, Fukuhara H, Kurokawa M, Izumi T, Suzuki H, Naito S, Nishida H, Kato T, Tsuchiya N.Int Urol Nephrol. 2019 Feb;51(2):239-245. doi: 10.1007/s11255-018-02066-1. Epub 2019 Jan 2.

Abstract

We investigated the clinical efficacy of the Triple D score (TrD-S) on stone-free rate (SFR) prediction following shockwave lithotripsy (SWL) for renal stones 10-20 mm in diameter and modified the scoring system to improve outcome prediction. METHODS: We retrospectively examined clinical data from the medical records of 226 consecutive patients who underwent SWL for 10-20 mm kidney stones. The TrD-S was calculated according to the cutoffs of < 150 mm3 for stone volume, < 600 Hounsfield unit for stone density, and < 12 cm for skin-to-stone distance on computed tomography. The Quadruple D score was defined as the sum of the TrD-S and stone location (0/1 point for intrarenal stone distribution at lower/non-lower poles, respectively). Complete clearance 3 months after the final SWL was considered the stone-free status. RESULTS: The residual group (n = 102) had significantly older age, larger stones, higher stone density, higher lower-pole stone incidence, and lower TrD-S than the stone-free group (n = 124). In the multivariate analysis, age, TrD-S, and non-lower-pole stones independently predicted the SFR. The TrD-Ss of 0, 1, 2, and 3 points showed SFRs of 40.0%, 51.9%, 73.0%, and 100.0%, respectively. The Quadruple D scores of 0, 1, 2, 3, and 4 points showed SFRs of 0.0%, 37.9%, 54.5%, 84.4%, and 100.0%, respectively, with better prediction accuracy than the TrD-S (p = 0.01). CONCLUSIONS: The TrD-S is successfully validated for use in Japanese patients with 10-20-mm renal stones. Simple addition of the stone location to the TrD-S could reinforce SFR prediction after SWL.

Comment Peter Alken

The Triple D score - composed of SSD, stone density, and stone volume - was introduced in 2015 (1) and was revalidated and confirmed by others, who pointed out the additive predictive power of stone location (2 ).
Interestingly in the present paper on Japanese patients the SSD which is related to the BMI had no significant effect on the ESWL outcome. The authors’ explanation is that obesity in Japanese people is rare with 2–3% of the Japanese population, in contrast to the 10–20% in Europe and the USA.
In only 50 % was a stone analysis available in both groups and the failure rate showed no correlation to the stone analysis. However, Calcium oxalate was not differentiated into Calciumoxalate-monohydrate which is more resistant to ESWL and Calciumoxalate-dihydrate which is more amenable to ESWL.
Otherwise this is a good contribution to an easy and better patient selection for ESWL.

1 Tran TY, McGillen K, Cone EB, Pareek G (2015) Triple D Score is a reportable predictor of shockwave lithotripsy stone-free rates. J Endourol 29(2):226–230
2 Ozgor F, Tosun M, Kayali Y, Savun M, Binbay M, Tepeler A (2017) External validation and evaluation of reliability and validity pf the Triple D Score to predict stone-free status after extracorporeal shockwave lithotripsy. J Endourol 31(2):169–173

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Reesink DJ et al., 2018: Extracorporeal shock wave lithotripsy under intravenous sedation for treatment of urolithiasis

Reesink DJ, Scheltema JMW, Barendrecht MM, Boeken Kruger AE, Jansonius A, Wiltink J, van der Windt F.

Scand J Urol. 2018 Nov 18:1-6. doi: 10.1080/21681805.2018.1524398. [Epub ahead of print]

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Bjazevic J et al, 2018: Stones in pregnancy and pediatrics.

Bjazevic J, Razvi H.
Asian J Urol. 2018 Oct;5(4):223-234. doi: 10.1016/j.ajur.2018.05.006. Epub 2018 Jun 5. Review. FREE ARTICLE

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Zewin TS et al, 2018: Efficacy and safety of low-intensity shock wave therapy in penile rehabilitation post nerve-sparing radical cystoprostatectomy: a randomized controlled trial.

Zewin TS, El-Assmy A, Harraz AM, Bazeed M, Shokeir AA, Sheir K, Mosbah A.
Int Urol Nephrol. 2018 Sep 19. doi: 10.1007/s11255-018-1987-6. [Epub ahead of print]

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Proietti S et al, 2018: Italian endourological panorama: results from a national survey.

Proietti S, Somani BK, Pietropaolo A, Saitta G, Rodríguez-Socarrás ME, Rosso M, Bellinzoni P, Gaboardi F, Giusti G.
Cent European J Urol. 2018;71(2):190-195. doi: 10.5173/ceju.2018.1623. Epub 2018 Mar 27. FREE ARTICLE

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Connors BA et al, 2018: Preliminary Report on Stone Breakage and Lesion Size Produced by a New Extracorporeal Electrohydraulic (Sparker Array) Discharge Device.

Connors BA, Schaefer RB, Gallagher JJ, Johnson CD, Li G, Handa RK, Evan AP.
Urology. 2018 Mar 26. pii: S0090-4295(18)30275-9. doi: 10.1016/j.urology.2018.03.020. [Epub ahead of print]. FREE ARTICLE

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Streeper NM, 2018: Asymptomatic Renal Stones-to Treat or Not to Treat.

Streeper NM.
Curr Urol Rep. 2018 Mar 17;19(5):29. doi: 10.1007/s11934-018-0782-3. Review.

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Shoar K et al, 2017: Tracking kidney stones in a homogeneous medium using a trilateration approach.

Shoar K, Turney BW, Cleveland RO.

J Acoust Soc Am. 2017 Dec;142(6):3715. doi: 10.1121/1.5017718. FREE ARTICLE 

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Cunitz BW et al, 2017: Characterizing the Acoustic Output of an Ultrasonic Propulsion Device for Urinary Stones.

Cunitz BW, Dunmire B, Bailey MR.

IEEE Trans Ultrason Ferroelectr Freq Control. 2017 Dec;64(12):1818-1827. doi: 10.1109/TUFFC.2017.2758647. Epub 2017 Oct 2. FREE ARTICLE 

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López-Acón JD et al, 2017: Analysis of the Efficacy and Safety of Increasing the Energy Dose Applied Per Session by Increasing the Number of Shock Waves in Extracorporeal Lithotripsy: A Prospective and Comparative Study.

López-Acón JD, Budía Alba A, Bahílo-Mateu P, Trassierra-Villa M, de Los Ángeles Conca-Baenas M, de Guzmán Ordaz-Jurado D, Boronat FT.

J Endourol. 2017 Dec;31(12):1289-1294. doi: 10.1089/end.2017.0261. Epub 2017 Nov 15.

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Wu W et al, 2017: How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for bole (EPVL).

Wu W, Yang Z, Tang F, Xu C, Wang Y, Gu X, Chen X, Wang R, Yan J, Wang X, Gao W, Hou C, Guo J, Zhang J, Gurioli A, Ye Z, Zeng G.

World J Urol. 2017 Dec 1. doi: 10.1007/s00345-017-2123-4. [Epub ahead of print]

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Cevik B et al, 2017: Procedural sedation and analgesia for pediatric shock wave lithotripsy: a 10 year experience of single institution.

Cevik B, Tuncer M, Erkal KH, Eryildirim B, Sarica K.

Urolithiasis. 2017 Jun 22. doi: 10.1007/s00240-017-0992-z. [Epub ahead of print]

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Nielsen TK et al., 2017: Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones.

Nielsen TK, Jensen JB.

BMC Urol. 2017 Jul 27;17(1):59. doi: 10.1186/s12894-017-0249-8. FREE ARTICLE

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He XZ et al, 2017: Analysis of the safety and efficacy of combined extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy for the treatment of complex renal calculus

He XZ, Ou TW, Cui X, Li J, Wang SH.

Eur Rev Med Pharmacol Sci. 2017 Jun;21(11):2567-2571

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Van Besien J et al, 2017: Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study.

Van Besien J, Uvin P, Hermie I, Tailly T, Merckx L.

Biomed Res Int. 2017;2017:7802672. doi: 10.1155/2017/7802672. Epub 2017 May 15

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May PC et al, 2017: Detection and Evaluation of Renal Injury in Burst Wave Lithotripsy Using Ultrasound and Magnetic Resonance Imaging.

May PC, Kreider W, Maxwell AD, Wang YN, Cunitz BW, Blomgren PM, Johnson CD, Park JSH, Bailey MR, Lee D, Harper JD, Sorensen MD.

J Endourol. 2017 Jun 16. doi: 10.1089/end.2017.0202. [Epub ahead of print]. FREE ARTICLE

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Chan LH et al, 2017: Primary SWL Is an Efficient and Cost-Effective Treatment for Lower Pole Renal Stones Between 10 and 20 mm in Size: A Large Single Center Study.

Chan LH, Good DW, Laing K, Phipps S, Thomas BG, Keanie JY, Tolley DA, Cutress ML.

J Endourol. 2017 Mar 29. doi: 10.1089/end.2016.0825. [Epub ahead of print]

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Hallmann S et al, 2017: Successful evacuation of large perirenal hematoma after extracorporeal shock wave lithotripsy (ESWL) - step 1 of the IDEAL recommendations of surgical innovation.

Hallmann S, Petersein J, Ruttloff J, Ecke TH.

Clin Case Rep. 2017 Jan 16;5(2):123-125. doi: 10.1002/ccr3.792. FREE ARTICLE

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Lin G et al, 2017: In Situ Activation of Penile Progenitor Cells With Low-Intensity Extracorporeal Shockwave Therapy.

Lin G, Reed-Maldonado AB, Wang B, Lee YC, Zhou J, Lu Z, Wang G, Banie L, Lue TF.

J Sex Med. 2017 Feb 28. pii: S1743-6095(17)30083-8. doi: 10.1016/j.jsxm.2017.02.004. [Epub ahead of print]

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Javanmard B et al, 2016: Retrograde Intrarenal Surgery Versus Shock Wave Lithotripsy for Renal Stones Smaller Than 2 cm: A Randomized Clinical Trial.

Javanmard B, Kashi AH, Mazloomfard MM, Ansari Jafari A, Arefanian S.

Urol J. 2016 Oct 10;13(5):2823-2828.

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Alavi Tamaddoni H et al, 2016: Enhanced High-Rate Shockwave Lithotripsy Stone Comminution in an In Vivo Porcine Model Using Acoustic Bubble Coalescence.

Alavi Tamaddoni H, Roberts WW, Duryea AP, Cain CA, Hall TL.

J Endourol. 2016 Dec;30(12):1321-1325. FREE ARTICLE

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Vogt B et al, 2016: MiniJFil®: A New Safe and Effective Stent for Well-Tolerated Repeated Extracorporeal Shockwave Lithotripsy or Ureteroscopy for Medium-to-Large Kidney Stones?

Vogt B, Desfemmes FN, Desgrippes A, Ponsot Y.

Nephrourol Mon. 2016 Aug 13;8(5):e40788. FREE ARTICLE

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Vaysse T et al, 2016: Efficacy and safety of extracorporeal shock wave lithotripsy for chronic pancreatitis.

Vaysse T, Boytchev I, Antoni G, Croix DS, Choury AD, Laurent V, Pelletier G, Buffet C, Bou-Farah R, Carbonnel F.

Scand J Gastroenterol. 2016 Aug 9:1-6. [Epub ahead of print]

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Zhang X et al, 2016: Low-Energy Shockwave Therapy Improves Ischemic Kidney Microcirculation.

Zhang X, Krier JD, Amador Carrascal C, Greenleaf JF, Ebrahimi B, Hedayat AF, Textor SC, Lerman A, Lerman LO.

 J Am Soc Nephrol. 2016 Jun 13. pii: ASN.2015060704. [Epub ahead of print]. FREE ARTICLE

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Uğuz S et al, 2016: Medical ozone therapy reduces shock wave therapy-induced renal injury.

Uğuz S, Demirer Z, Uysal B, Alp BF, Malkoc E, Guragac A, Turker T, Ateş F, Karademir K, Ozcan A, Yildirim I, Korkmaz A, Guven A.

Ren Fail. 2016 Jul;38(6):974-81. doi: 10.3109/0886022X.2016.1172941. Epub 2016 Apr 20.

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Sharma NL et al, 2016: Shock-wave lithotripsy: variance within UK practice.

Sharma NL, Alexander CE, Grout E, Turney BW.

Urolithiasis. 2016 May 23. [Epub ahead of print] 

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Lantz AG et al, 2016: Shockwave lithotripsy practice pattern variations amongst and between American and Canadian urologists: in support of guidelines.

Lantz AG, McKay JP, Ordon M, Pace K, Monga M, Honey RJ.

J Endourol. 2016 Jun 1. [Epub ahead of print]

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May PC et al, 2016: Ultrasonic propulsion of kidney stones.

May PC, Bailey MR, Harper JD.

Curr Opin Urol. 2016 Feb 3. [Epub ahead of print]

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Sfoungaristos S et al, 2015: History of Ureteral Stenting Negatively Affects the Outcomes of Extracorporeal Shockwave Lithotripsy. Results of a Matched-pair Analysis.

Sfoungaristos S, Gofrit ON, Pode D, Landau EH, Yutkin V, Latke A, Duvdevani M.

Prague Med Rep. 2015;116(3):225-32. doi: 10.14712/23362936.2015.62.

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Bohris C et al, 2015: Improvement of SWL Efficacy: Reduction of the Respiration-Induced Kidney Motion by Using an Abdominal Compression Plate.

Bohris C, Stief CG, Strittmatter F.

J Endourol. 2015 Dec 18. [Epub ahead of print]

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Schnabel MJ et al, 2015: [Shock wave lithotripsy in Germany : Results of a nationwide survey].

Schnabel MJ, Brummeisl W, Burger M, Rassweiler JJ, Knoll T, Neisius A, Chaussy CG, Fritsche HM.

Urologe A. 2015 Sep;54(9):1277-82. doi: 10.1007/s00120-015-3920-2. German. 

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Lee FC et al, 2015: Renal Vasoconstriction Occurs Early During Shockwave Lithotripsy in Humans.

Lee FC, Hsi RS, Sorensen MD, Dunmire B, Liu Z, Bailey MR, Harper JD. 

J Endourol. 2015 Oct 26. [Epub ahead of print]. FREE ARTICLE 

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Dogan HS et al, 2015: A new nomogram for prediction of outcome of pediatric shock-wave lithotripsy.

Dogan HS, Altan M, Citamak B, Bozaci AC, Karabulut E, Tekgul S.
J Pediatr Urol. 2015 Apr;11(2):84.e1-6. doi: 10.1016/j.jpurol.2015.01.004. Epub 2015 Mar 5   

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Cakiroglu B et al, 2015: The effect of inclined position on stone free rates in patients with lower caliceal stones during SWL session.

Cakiroglu B, Sinanoglu O, Tas T, Hazar IA, Balci MB.
Arch Ital Urol Androl. 2015 Mar 31;87(1):38-40. doi: 10.4081/aiua.2015.1.38 

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Hughes SF et al, 2015: A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones.

Hughes SF, Thomas-Wright SJ, Banwell J, Williams R, Moyes AJ, Mushtaq S, Abdulmajed M, Shergill I.
PLoS One. 2015 May 4;10(5):e0125840. doi: 10.1371/journal.pone.0125840. eCollection 2015. FREE ARTICLE 

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Yencilek E et al, 2015: The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

Yencilek E, Sarsılmaz A, Kilickesmez O, Koyuncu H, Eryildirim B, Gurses B, Bastug Y, Erihan B.
Med Ultrason. 2015 Jun;17(2):175-9. doi: 10.11152/mu.2013.2066.172.dyr. 

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de Icaza-Herrera M et al, 2015: Combined short and long-delay tandem shock waves to improve shock wave lithotripsy according to the Gilmore-Akulichev theory.

de Icaza-Herrera M, Fernández F, Loske AM
Ultrasonics. 2015 Apr;58:53-9. doi: 10.1016/j.ultras.2014.12.002. Epub 2014 Dec 19. 

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Qadri SS et al, 2015: Effects and outcome of Tamsulosin more than just stone clearance after extracorporeal shock wave lithotripsy for renal calculi.

Qadri SS, El Khalid S, Mahmud SM 

J Pak Med Assoc. 2014 Jun;64(6):644-8. 

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Bhojani N et al, 2015: Lithotripter Outcomes in a Community Practice Setting: Comparison of an Electromagnetic and an Electrohydraulic Lithotripter.

Bhojani N, Mandeville JA, Hameed TA, Soergel TM, McAteer JA, Williams JC Jr, Krambeck AE, Lingeman JE
J Urol. 2014 Oct 8. pii: S0022-5347(14)04607-2. doi: 10.1016/j.juro.2014.09.117. [Epub ahead of print]. FREE ARTICLE 

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Ramaswamy K et al, 2015: Targeted Microbubbles: A Novel Application for Treatment of Kidney Stones

Ramaswamy K, Marx V, Laser D, Kenny T, Chi T, Bailey M, Sorensen M, Grubbs R, Stoller M
BJU Int. 2014 Nov 17. doi: 10.1111/bju.12996. [Epub ahead of print]. FREE ARTICLE 

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Tailly GG et al, 2014: Optical Coupling Control: An Important Step Toward Better Shockwave Lithotripsy.

Tailly GG, Tailly-Cusse MM.

J Endourol. 2014 Aug 12. [Epub ahead of print] 

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