?However these forces can also cause trauma which can result in
haemorrhage. 

?ESWL works on the basis of both dynamic and mechanical forces such
as shear, cavitation and spalling with the most important being cavitation.

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?ESWL is a non-invasive procedure that is highly efficient in
treating both kidney and ureteral stones. Its role is to break up these stones

?ESWL6 was first presented in the
1980’s in Western Germany.

?Complications can arise from the stone fragments.

?These complications include:

?Renal haemorrhage

?Cardiovascular

?Gastrointestinal

?The above mentioned are tissues that can all be affected by
extracorporeal shock wave lithotripsy

?The predisposing factors that influence ESWL failures are the
composition of the stone, location, size, the number of stones present at the
one time, renal structure as well as the rate of the shock wave.

?The ability of ESWL to work is dependent on the size of the stone.
The bigger the stone , the less likely ESWL is to work effectively.

?ESWL can cause trauma to the renal system more specifically to its
vascular flow. Due to this trauma bacteria that is present in the urine could
enter into the bloodstream and cause issues for other body systems.

?

?Another complication associated with ESWL are cardiac arrhythmias.
As arrhythmias can occur in patients with pacemakers, they can be treated with
ESWL but more precautions must be taken.

?The procedure will then be done under the watchful eye of a
cardiologist.

?A positive to ESWL is that it is a non- invasive procedure meaning
that recovery time should be significantly less 

?

?Another complication associated with ESWL are cardiac arrhythmias.
As arrhythmias can occur in patients with pacemakers, they can be treated with
ESWL but more precautions must be taken.

?The procedure will then be done under the watchful eye of a
cardiologist.

?A positive to ESWL is that it is a non- invasive procedure meaning
that recovery time should be significantly less 

-It’s
a non-invasive treatment modality for urolithiasis besides conservative stone
management. (1)

-Uses
the basic science of shock wave lithotripsy

-The
technique minimize morbidity and improve fragmentation.

-It
remains the most  sought after and most
commonly performed procedure for stone management, as patients and physicians
recognize that the balance tips heavily towards benefit over risk.

-Shock
wave lithotripsy remains the cornerstone for guidelines on management of renal
and ureteral stones.

?Uses coil and a metal membrane, placed opposite each other.

?Generating a high current pulse to the coil, strong magnetic field
is produced.

?Slow, low-pressure acoustic pulse in water is created.

?Wave is focused by an acoustic lens to the stones in a nonlinear
fashion.

?

•Uses mechanical stress by the application
of electricity.

•Crystals are mounted on a spherical
surface.

•A high voltage pulse is applied, causing
them to contract and then expand

•The expansion generates a low pressure
pulse in the surrounding water.

•Producing self-focusing (due to the
geometric shape of the sphere)

Pregnancy, Uncontrolled urinary tract infections, Anatomic obstruction distal
of the stone, Severe obesity, exceeding weight specification and penetration
depth of shock wave, Skeletal malformations making positioning and targeting
impossible. 

and non-linear wave shock on the stones.

STATE OF THE ART.

– It has replaced other treatment
techniques for the majority of surgical calculi in the upper urinary tract
through the combination of lithotripter and endourological procedures.

-use
on common bile duct stones combined with endosurgical or
radiological manipulations.


modified kidney lithotriptor
gallstones have been treated successfully.


Currently, been use for waning, particularly with the advent of minimally
invasive ureteroscopic
approaches.

-“Flexible
Ureteroscopy and Laser Lithotripsy intervention has proven to be not only a
less invasive treatment but also a successful with a low complication and stone
free rate (SFR) for renal calci larger than 2 cm”.

?

?

?A development in this field in the introduction of percutaneous
nephrolithotomy7 (PNL).

?Even though PNL was introduced in the 1970’s it has since been
further developed.

?This particular treatment is minimally invasive.

?With the introduction of ESWL in the 1980’s PNL was not as popular
but due to the restrictions of ESWL, PNL’s role was on the increase.

?PNL can now be used as the first option in the treatment of
numerous or larger kidney stones.

?

?

?

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