Direction of shockwave entry is most important as far as results and injury to the organ is concerned.
According to me the best direction to treat the Urinary stone disease is retroperitoneal (Posterior) approach for renal and upper ureteic calculus.
As illustrated in the diagram if we have anterior or transperitoneal (Anteriror) approach for ureteric calculus changes of intestinal injury is high. Ureter being retroperitoneal organ, its advisable that shockwave axis is retroperitoneal and not laterally or anteriorly.
Second energy and frequecy for ureteric stone is high, which can lead to more damage to abdominal organ in anterior approach of shockwave.
"ALWAYS USE POSTERIOR APPROACH IF YOU ARE TREATING URETERIC CALCULUS."
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