Not all shockwaves created by different lithotripters are equal

Shockwave lithotripsy revolutionized the treatment of kidney stones in the early 1980s – representing a huge leap in advancement of technology; from open surgical techniques to non-invasive ones.

Physicians took to the leap in technology with enthusiasm, and patients reaped the benefits. Over the years, systems became more user friendly, but also varied in key aspects.

The methods used to generate shockwaves were different – each method of shockwave generation having it’s own unique characteristics.

Developments in imaging modality in x-rays and ultrasound also provided a difference, with modern ultrasound providing better specificity and sensitivity than earlier versions.

The independent development of modern shockwave and imaging technology in certain devices has led to a variation of results in ESWL, depending on the specific device.

As such – “Not all shockwaves created by different lithotripters are equal”, as differences in shockwave generation and imaging modality are factors which influence treatment outcomes.

When evaluating Lithotripsy methods, physicians should bear this in mind – especially when comparing results of endourology with shockwave lithotripsy.

For further insight and perspective, it is recommended that ESWL and other methods of lithotripsy be classified further.

To remain truly unbiased, we recommend the following key factors should be highlighted in published articles (both for and against ESWL):

1. Shockwave generator technology
2. Imaging modality used
3. Energy delivered
4. Frequency of shockwaves