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Ureteroscopy vs. shock wave lithotripsy: Advances spell positive future for both

I think the future in stones is really exciting. The question that comes up at scientific meetings is, is there is a role for shock wave lithotripsy in the future and can stones be treated entirely endoscopically? I think there’s a place for both technologies, and I think that what urologists are trying to do now is better understand who is going to be best treated with shock wave lithotripsy and who is going to be best treated with ureteroscopy. The magnitude of the innovations we’ve seen with the endoscopic approach in the past decade has been very exciting to those of us who treat stones commonly, because we are able to do things now much more easily, much more safely, and much more rapidly…

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Articles of Interest

Lithotripsy for stones: What to expect

The two types of lithotripsy are extracorporeal shock wave lithotripsy (ESWL) and laser lithotripsy. Laser lithotripsy is sometimes abbreviated as FURSL (flexible ureteroscopy and laser lithotripsy) because doctors use a tool called a ureteroscope.

Blasting of Kidney Stones Has Risks, Study Reports

The use of shock waves to pulverize kidney stones into sand-like material significantly increases the risk for diabetes and high blood pressure later in life, according to the longest follow-up study of the popular therapy.

Controversies in Urology: Shock Wave Lithotripsy Should Be Retired

Dr. Clayman summarized the discussion by noting that SWL is not an “on-or-off” switch. Over the years, SWL usage dropped from 70% to 30%, but this depends on how we train our urologists today. The future of SWL is dependent on the re-invention of SWL and on retraining our future urologists.

Doctors Take Aim At Epidemic Kidney Stones With Lasers

Lasers are becoming the treatment-of-choice for kidney stones in academic medical centers like the Mass General. Another alternative is so-called shock-wave lithotripsy, in which a machine uses high-energy sound waves to smash stones. The advantage is that it's noninvasive, that is, it doesn't require putting any equipment into the body.

Lithotripsy: A Kidney Stone's Worst Friend

The sound waves, directed by the surgeon on a video-game like screen, will come from many directions and travel through the jelly bag that will be against my lower back to collide at the point of the stone. Voila! No more kidney stone!

Non-invasive lithotripsy leads to more treatment for kidney stones

Within 120 days of the initial procedure, approximately one in five of the patients needed a second treatment. The researchers focused their comparison on patients who were equally qualified for either procedure. Among that group, 11 percent of patients undergoing shock wave lithotripsy needed a second procedure, while less than 1 percent of ureteroscopy patients needed an additional treatment.

Recent Advances in the Science of Burst Wave Lithotripsy and Ultrasonic Propulsion

Nephrolithiasis is a common, painful condition that requires surgery in many patients whose stones do not pass spontaneously. Recent technologic advances have enabled the use of ultrasonic propulsion to reposition stones within the urinary tract, either to relieve symptoms or facilitate treatment. Burst wave lithotripsy (BWL) has emerged as a noninvasive technique to fragment stones in awake patients without significant pain or renal injury.

Suffer From Kidney Stones? Riding A Roller Coaster May Help

Today, common medical procedures to remove kidney stones include sending shock waves to the stone to break it up ― a procedure called lithotripsy ― or removal with a long tool. Though those procedures are still the gold standard, Wartinger suggested patients might want to talk to their doctors about riding a roller coaster as a first intervention.

Ureteroscopic lithotripsy as day care procedure: Our early experience in Regional Institute of Medical Sciences

Recent advances in endourology and utilization of shock wave physics in urological stone disease have changed the management of urolithiasis altogether. With the emergence of fine ureteroscopes, intracorporeal lithotripsy with ureterorenoscopy has emerged as treatment of choice for ureteric (especially mid and lower) stones.

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

In this paper, the relative benefits and harms of the two most commonly offered treatment options for urinary stones located in the upper ureter were reviewed. We found that both treatments are safe and effective options that should be offered based on individual patient circumstances and preferences.

Resources

Shockwave lithotripsy (ESWL)

The advantage of this treatment approach is that instruments may not need to be introduced into your body (unless your stone is large, in which case a stent is usually placed at the time of surgery).