HOW UROLOGISTS ARE TRAINED IN SWL ?

One of the advantages of SWL relative to other surgical techniques for the treatment of patients with stone disease is its short learning curve. Indeed, SWL may be performed following a short training period for urologists, and there are even reports of SWL being successfully administered by medical technicians [1]. However, when SWL was first introduced, the training was rigorous and a typical training program consisted of the management of 25 consecutive patients for 5 to 10 working days [2]. Such experience was mandated to include pre-treatment evaluation and post-treatment patient care. The director of the SWL center was further required to have personal experience with at least 200 patients. A more recent survey of Canadian Urological Association members found that 70% of respondents rated SWL training as useful and relevant to practice [3]. However, at present there is no formal curriculum in SWL training, and organizations such as the American Urological Association do not have a formal didactic in this technology. We contend that SWL should not be viewed as routine, and that proper practice demands that the person in charge have a good grasp of the scientific basis of lithotripsy and an upto- date understanding of the mechanisms of SW action. In this regard, a greater emphasis on the training of urologists and lithotripsy technicians would be welcomed.

1. Ilker Y, Erton M, Simsek F, Akada A: Extracorporeal shock wave lithotripsy (ESWL) for urinary tract stones using Dornier MFL 5000, performed by the technician. Int Urol Nephrol 27: 511, 1995
2. Cockett AT: Extracorporeal shock wave lithotripsy training in the United States. J Urol 135: 1229, 1986
3. Morrison KB, MacNeily AE: Core comptencies in surgery: evaluating the goals of urology residency training in Canada. Can J Surg 49: 259, 2006

Article acceptance in Indian journal of Urology.

Today I got email from editor of Indian Journal of urology regarding provizinal acceptance of article on Lithotripsy in patient with renal stone associated with angiomyolipoma (AML).
Complete clearance was achived in one session. Technique was applying physics associated with shockwave, and not just shockwave.
Message:
"If we spend time in mastering the technique we would never fail in lithotripsy"

Its always application of technology which fails and not the technology!!!!!!!