Lithotripsy

Abstract Shock wave lithotripsy (SWL) is the process of fragmentation of renal or ureteric stones by the use of repetitive shock waves generated outside the body and focused onto the stone. Following its introduction in 1980, SWL revolutionized the treatment of kidney stones by offering patients a n...

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Bibliographic Details
Published in:Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine Journal of engineering in medicine, 2010-01, Vol.224 (2), p.317-342
Main Authors: Leighton, T G, Cleveland, R O
Format: Article
Language:English
Subjects:
Acoustics
Animals
Computer Simulation
Forecasting
Fragmentation
Humans
Hypertension
Injuries
Kidney - injuries
Kidney Calculi - therapy
Kidney stones
Kidneys
Knowledge bases (artificial intelligence)
Lithotripsy
Lithotripsy - adverse effects
Lithotripsy - methods
Lithotripsy - trends
Mechanical engineers
Medical treatment
Models, Biological
Nephrolithiasis
Nephrology
Optimization
Patients
Shock waves
Side effects
Sonication - adverse effects
Sonication - methods
Sonication - trends
Sound
State-of-the-art reviews
Stone
Technology utilization
Ureter
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Summary:Abstract Shock wave lithotripsy (SWL) is the process of fragmentation of renal or ureteric stones by the use of repetitive shock waves generated outside the body and focused onto the stone. Following its introduction in 1980, SWL revolutionized the treatment of kidney stones by offering patients a non-invasive procedure. It is now seen as a mature technology and its use is perceived to be routine. It is noteworthy that, at the time of its introduction, there was a great effort to discover the mechanism(s) by which it works, and the type of sound field that is optimal. Although nearly three decades of subsequent research have increased the knowledge base significantly, the mechanisms are still controversial. Furthermore there is a growing body of evidence that SWL results in injury to the kidney which may have long-term side effects, such as new onset hypertension, although again there is much controversy within the field. Currently, use of lithotripsy is waning, particularly with the advent of minimally invasive ureteroscopic approaches. The goal here is to review the state of the art in SWL and to present the barriers and challenges that need to be addressed for SWL to deliver on its initial promise of a safe, effective, non-invasive treatment for kidney stones.
ISSN:0954-4119
2041-3033
DOI:10.1243/09544119JEIM588