Treatment protocols to reduce injury and improve stone breakage in SWL

James A. McAteer, Andrew P. Evan, Bret A. Connors, Yuri A. Pishchalnikov, James C. Williams, James E. Lingeman

Research output: Chapter in Book/Report/Conference proceedingConference contribution

3 Scopus citations


Here we provide a capsule summary of key observations showing that adverse effects can be reduced and stone breakage outcomes can be improved by the choice of the treatment protocol used in SWL. The take home message is-technique in lithotripsy can be used to significant advantage. SW-rate is key, and so is the sequence of SW delivery. Patient studies have shown that stone breakage is significantly improved at 60SW/min compared to a rate of 120SW/min, and laboratory experiments with pigs show that acute SWL injury to the kidney can be reduced dramatically by further slowing the SW firing rate to 30SW/min. The sequence of SW administration has a profound effect on the kidney, and renal injury is significantly reduced when the treatment protocol incorporates a priming dose of SW's followed by a brief pause before treatment is resumed. Continued developments in lithotripsy technology are welcome and will hopefully lead to improved SWL systems. Current experience suggests, however, that technology is not a substitute for expert technique, and attention to the fundamentals of SW delivery is essential to achieve the best possible outcomes regardless of the lithotripter at hand.

Original languageEnglish (US)
Title of host publicationRenal Stone Disease 2 - 2nd International Urolithiasis Research Symposium
Number of pages6
StatePublished - Oct 22 2008
Event2nd International Urolithiasis Research Symposium - Indianapolis, IN, United States
Duration: Apr 17 2008Apr 18 2008

Publication series

NameAIP Conference Proceedings
ISSN (Print)0094-243X
ISSN (Electronic)1551-7616


Other2nd International Urolithiasis Research Symposium
CountryUnited States
CityIndianapolis, IN


  • Animal models
  • Kidney
  • Kidney stones
  • Shock wave lithotripsy
  • Trauma

ASJC Scopus subject areas

  • Physics and Astronomy(all)

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