Burst wave lithotripsy – the new evolution stage of extracorporeal shock-wave lithotripsy

Urolithiasis is currently one of the most urgent problems in the world. Every eleventh worldwide inhabitant suffers from this disease. Previously, the only way to get rid of kidney stones and the urinary tract was open surgery, which was characterized by high trauma. Over the past decades, the development of technologies has made a significant contribution to the development of new methods of urolithiasis treatment. One of these methods is extracorporeal shock wave lithotripsy (ESWL). The first lithotripter Dornier HM-1 was produced in 1980. Subsequent models have got many changes, both in terms of ergonomics and power. The researchers noticed that the efficiency of stone crushing in the Dornier HM-1 lithotripter was higher than in newer models since the lower power provided the less intensive formation of cavitation bubbles that prevent the effective transit of subsequent waves through the stone. Nowadays, a new method of remote stone crushing is being developed based on low-amplitude high-frequency technology combined with ultrasonic propulsion, which is the main difference from traditional shock-wave lithotripters. The new technology of stone crushing is called «burst wave lithotripsy» (BWL). Currently, the data have been obtained that this method is more effective in terms of crushing quality and less traumatic.

Shock Wave Lithotripsy: Application and Future Direction

Shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotomy all have an important role in the management of patients with kidney and ureteral stones. SWL remains popular with providers and is preferred by many patients. This review describes the pros and cons of these procedures, the appropriate conditions for SWL, indicators for successful outcomes for SWL, effective SWL technique, and adverse effects. Also reported are the imaging and therapeutic research to improve SWL effectiveness. This may expand the use of SWL by addressing some of SWL’s current limitations and lead to improved patient outcomes. This review contains 5 highly rendered figures, 3 tables, and 85 references Key words: burst wave lithotripsy, cavitation, comminution, coupling, endourology, kidney injury, kidney stones, minimally invasive, nephrolithiasis, shock wave lithotripsy, stone-free rate, ultrasonic propulsion, urolithiasis