Recording: Present and Future of SWL
SWL is not dead.
Following its clinical introduction in the early 1980s, Shock Wave Lithotripsy (SWL) was proven as a reliable and effective alternative treatment for urinary tract stones. At present, SWL is the only non-invasive method that requires no anaesthesia and hospitalisation.
| Organiser | European School of Urology (ESU) |
|---|---|
| CME | Not approved |
| Duration | Approx. 60 minutes |
The evolution of percutaneous and ureteroscopic stone management may have changed the management of relatively large stones (larger than 20mm) in the last 2 decades, but a guidelines-based approach states that with the right patient and when stone selection is applied, SWL is still the preferred treatment choice for stones less than 15mm in size. SWL is not dead; it remains effective in experienced hands.
Emerging technologies
Since the introduction of the HM3 shock wave lithotripter, changes in focal zone area, energy, and delivery rate, as well as, imaging modalities for monitoring stone fragmentation were made to improve results. However, the future of lithotripsy seems to move toward the improvement in safety and fragmentation such as microbubble technology. Newer technology lithotripters, such as histotripsy and burst wave lithotripsy, work by varying the delivery of ultrasound waves to a stone. These technologies seem to hold the future of extracorporeal shockwave treatment.