Extracorporeal shock wave lithotripsy:four decades with lessons learnt
The emergence of extracorporeal shock wave lithotripsy(SWL)in 1980 undoubtedly brought revo-lutionary changes to the treatment of urolithiasis patients,having treated millions of stone patients to date.How-ever,the treatment outcomes of SWL are influenced by the level of operation,and the accurate use of technology and at-tention to detail are crucial for achieving satisfactory treatment results,especially for ureteral stones.SWL is not only minimally invasive and cost-effective but can also be performed without general or local anesthesia,and it can even be con-ducted in outpatient settings without surgical facilities.Additionally,this anesthesia-free stone treatment method has ena-bled healthcare workers to avoid exposure to aerosols of the coronavirus during the COVID-19 pandemic.Furthermore,some minimally invasive adjunctive therapies that do not require anesthesia can treat some patients who have had unsuc-cessful SWL treatments.We have summarized various clinical issues encountered in the past forty years of using SWL and completed this review,summarizing practical and feasible information within the existing knowledge framework to provide robust reference and guidance for clinicians on balancing SWL treatment effectiveness and patient safety.
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