Shockwave Lithotripsy: Anecdotes and Insights

James E. Lingeman, Samuel C. Kim, Ramsay L. Kuo, James A. McAteer, Andrew P. Evan

Research output: Contribution to journalReview article

64 Scopus citations


Shockwave lithotripters have evolved considerably since the introduction of the Dornier HM3 machine 20 years ago. Although shockwave lithotripsy (SWL) remains the preferred treatment for the majority of symptomatic upper urinary-tract calculi, newer lithotripters are not as effective and may have a higher risk of side effects. Lack of progress in lithotripter evolution is attributable to inadequate understanding of how and why shockwaves produce effects on stone and tissue. Current knowledge suggests that stones fragment by the mechanisms of compression fracture, spallation, squeezing, and acoustic cavitation, while tissue damage from shockwaves is secondary to cavitation and non-cavitational forces such as sheer stress. It appears likely that most tissue damage from shockwaves is caused by cavitation. As the understanding of SWL matures, new lithotripter designs may emerge that truly represent an improvement on the original Dornier HM3 machine.

Original languageEnglish (US)
Pages (from-to)687-693
Number of pages7
JournalJournal of Endourology
Issue number9
StatePublished - Nov 2003

ASJC Scopus subject areas

  • Urology

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    Lingeman, J. E., Kim, S. C., Kuo, R. L., McAteer, J. A., & Evan, A. P. (2003). Shockwave Lithotripsy: Anecdotes and Insights. Journal of Endourology, 17(9), 687-693.