Current indications of extracorporeal shock wawe litho tripsy urolithiasis treatment - what has been changed?
Authors:
MUDr. Aleš Petřík, Ph.D.
Authors‘ workplace:
Urologické oddělení Nemocnice České Budějovice, a. s.
Published in:
Urol List 2008; 6(3): 14-21
Overview
Extracorporeal shock wave lithotripsy (ESWL) has been used in clinical practice since 1980. Even new lithotripters have been developed, it is not clear, if they can achieve better treatment results or not. Ureteroscopy, due to the progress in its development, has become an equivalent technique to SWL. Contribution of using non contrast spiral CT (NCSCT) as a diagnostic procedure is essential. On NCSCT scan is possible to measure the stone surface distance and NCSCT can estimate the stone composition, which has great influence on treatment results. There are no significant changes in indication of SWL in the treatment of renal stones. The stone diameter of 20 mm and anatomy of lower calyx are still the main limitation factors of indication of SWL treatment. Ureteroscopy has become the equivalent technique to ESWL in ureteric stone treatment. Using of analgesia and minimal invasivity are the main advantages of SWL. Return to basic research of shock waves physic and development of new lithotripters are essential, if SWL wants to play a significant role in urinary stone treatment.
Key words:
ureteric stone, therapy, SWL, ureteroscopy
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