|Year : 2015 | Volume
| Issue : 3 | Page : 189
Extracorporeal shock wave lithotripsy
Abdulaziz A Al-Quorain
Department of Internal Medicine, College of Medicine, University of Dammam, Dammam, kingdom of Saudi Arabia
|Date of Web Publication||3-Aug-2015|
Abdulaziz A Al-Quorain
P. O. Box 40001, Al-Khobar 31952
kingdom of Saudi Arabia
|How to cite this article:|
Al-Quorain AA. Extracorporeal shock wave lithotripsy. Saudi J Med Med Sci 2015;3:189
Extracorporeal shock wave lithotripsy (ESWL) was introduced to the clinical practice in 1980 in Munich, Germany. Since that time, it has changed the management of kidneys and upper gastrointestinal stones dramatically. ,
Extracorporeal shock wave lithotripsy is a noninvasive procedure for the treatment of kidney stones, as well as gallbladder, common bile duct, and pancreatic duct stones. , However, regarding kidney stones other invasive procedures such as percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) are more superior.  The management of renal stones can be classified into conservative management, ESWL, PCNL, RIRS, and endoscopic techniques. The American Urological Association's Stone Guideline Panel has classified ESWL as a potential first-line treatment for ureteral and renal stones smaller than 2 cm.  ESWL is considered as least invasive and a relatively safe procedure for treatment of kidney stones. However, it is accompanied by some side-effects and complications, requiring measures such as analgesics and sedatives to prevent them. 
Extracorporeal shock wave lithotripsy may be associated with morbidity due to the fragmented products, which can lead to lesions in the kidneys and the adjacent organs. There are absolute contraindications to ESWL, namely; acute urinary tract infections or urosepsis; coagulopathies, pregnancy, and obstruction distal to the stones. 
The overall complication rate of ESWL ranges from 5% to 20%. However, it is an efficient and noninvasive procedure for the management of kidney, gallbladder, common bile duct, and pancreatic duct stones. Hence, "ESWL delivered in an outpatient setting as an anesthesia-free treatment is still considered the first option for the majority of stones with a minimal number of complications. Treatment optimization by limiting renal damage and better selection of patients will offer maximum benefit to patients and physicians, besides being cost-effective treatment." 
In this issue, Dr. Darawany reviews ESWL and other modalities and their roles in the management of kidney stones.
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