title: [Shockwave lithotripsy: energy needed for fragmenting calculi].
abstract: Based on the experience with the Dornier HM-3 lithotripter, the author analyzes herein the adverse effects caused by extracorporeal shock wave lithotripsy. Although admittedly empirical, an attempt is made to establish the number of shock waves and pressure required to achieve stone fragmentation without causing injury to the kidney. The effects of lung, stomach, colon, and skin or muscle contusions, hematoma, renal scarification, decreases in renal function, elevations in liver enzymes, and pancreatitis are reported, as well as systemic effects such as hemoglobinemia and hemoglobinuria, hearing change, and potential excessive radiation exposure, etc. The estimate of shock wave energy is discussed, highlighting the importance of the number of shock waves over the energy of the shock wave, and attention is focussed on the concept of stone fragility. Although we can nearly define the upper limits of energy related to safety, the author concludes that currently many questions remain unanswered.
authors.forename: G W
authors.initials: GW
authors.lastname: Drach
mesh_terms: D055592:Biophysical Phenomena; D001703:Biophysics; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D014545:Urinary Calculi / Q000628:therapy*
vernacular_title: Litotricia por ondas de choque: energía necesaria para la fragmentación de los cálculos.