How can and should we optimize extracorporeal shockwave lithotripsy?

Urolithiasis. 2018 Feb;46(1):3-17. doi: 10.1007/s00240-017-1020-z. Epub 2017 Nov 25.


It is well recognized that the popularity of extracorporeal shock wave lithotripsy (SWL), despite its non-invasive character, has decreased during recent years. This is partly explained by the technological achievements in endoscopy and urologists' enthusiasm for such procedures. Another explanation is that many urologists have been insufficiently successful with SWL. The latter effect might to some extent be a result of the performance of the lithotripter used, but in too many cases, it is evident that the principles of how shock wave lithotripsy should be carried out are poorly applied. The purpose of this article is to emphasize some important aspects on how SWL best should be used. Based on decades of experience, it stands to reason that success with SWL does not come automatically and attention has to be paid to all details of this technique.

Keywords: Extracorporeal shockwave lithotripsy; Indications; Precautions; Renal stones; SWL; Treatment strategies; Ureteral stones.

Publication types

  • Review

MeSH terms

  • Humans
  • Kidney Calculi / therapy*
  • Lithotripsy / adverse effects
  • Lithotripsy / methods*
  • Lithotripsy / standards*
  • Practice Guidelines as Topic