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
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