ESWL in a Nutshell

• 17 Sep 2020 10:33:14 AM
• |Endo Urology

Dear All,

With advances in Technology with regards to management of Urolithiasis, ESWL has fallen into disfavour in many countries including India. At many centres it is sad to see the lithotripter unit, which held a pride of place, being isolated into a remote corner and often catching dirt.

ESWL as an option for treatment of Urolithiasis is still mentioned in the various Guidelines and mention it as a viable option. But Miniaturization of Equipments now available for both PCNL and Ureteroscopy seem to have led to the downfall of ESWL. The main fall of ESWL is created by our own folly in leaving the entire procedure from Localization to completion of treatment to the technicians which, I believe resulted in poor results. For any procedure to be successful, proper dedication is required which we as Urologists let go stating want of time. This is happening for many of the subspecialties from developing under the Umbrella of Urology due to the often heard statement ‘lack of time’.

ESWL is still a good procedure provided it is performed using strict criteria of selection. We did over indulge in performing ESWL with scant respect over indications. This is another reason for its downfall.

It is mentioned that the retreatment rates are high with ESWL as against PCNL and Ureteroscopy. This can be attributed once again to indiscriminate use with doubtful indications.

I am providing a Small Book published by Dornier titled ‘ESWL in a Nutshell – 2^nd Edition’ for your reading and understanding. This book provides most of the informations needed even today as regards ESWL. Though many of us may not be using ESWL as an alternative to the present options, it is essential for all of us to have some knowledge concerning the Physics of ESWL and the usage of ESWL

With warm regards,

Venu

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