Extracorporeal shock wave lithotripsy

Last revised by Mostafa Elfeky on 22 Apr 2021

Citation, DOI, disclosures and article data

Citation:

Knipe H, Elfeky M, Bell D, et al. Extracorporeal shock wave lithotripsy. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-43461

DOI:

https://doi.org/10.53347/rID-43461

Permalink:

https://radiopaedia.org/articles/43461

rID:

43461

Article created:

11 Mar 2016, Henry Knipe ◉ ◈

Disclosures:

At the time the article was created Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Last revised:

22 Apr 2021, Mostafa Elfeky ◉

Disclosures:

At the time the article was last revised Mostafa Elfeky had no recorded disclosures.

View Mostafa Elfeky's current disclosures

Revisions:

13 times, by 10 contributors - see full revision history and disclosures

Systems:

Gastrointestinal, Head & Neck, Urogenital

Tags:

urology, renal stones

Synonyms:

Extracorporeal shock wave lithotripsy (ESWL)
Shock wave lithotripsy (SWL)

Extracorporeal shock wave lithotripsy (ESWL) is a common non-invasive treatment for urolithiasis, and less commonly for pancreatic or salivary ductal stones ⁴. It is less successful in obese patients and with stones >2 cm. Children respond equally well or better to ESWL than adults ⁵.

The principle of extracorporeal shock wave lithotripsy is that focused shock waves cause stone fragmentation. Repetition of this process eventually leads to pulverization of the calculi. Radiologically these can be visualised during the treatment with either fluoroscopy or ultrasound imaging.

Contraindications

pregnancy
infection
obstruction of the urinary tract
abdominal aortic aneurysm
coagulopathy
use of anticoagulants, antiplatelets or some NSAID medications

Complications

steinstrasse: incomplete fragmentation that results in a pile-up of stone fragments that obstruct the ureter
renal haemorrhage is rare (<1%)
haematuria (adult) - is common in ESWL and is considered more of a side effect from the shock waves than a complication
urinoma ⁶