title: Adjuncts to improve outcomes of shock wave lithotripsy.
abstract: Shock wave lithotripsy (SWL) has been a major tool in the treatment of urinary stones for nearly three decades. In recent years, SWL technology has been less effective at fragmenting stones than earlier devices; thus, adjunctive maneuvers to improve stone-free rates after SWL have been required. This article summarizes several of these adjuncts, such as slower shock wave rate, the use of percussion therapy to clear fragments, medications to hasten expulsion of fragments, and appropriate selection and positioning of patients for SWL.
authors.affiliation: Department of Urology, Montefiore Medical Center and Albert Einstein School of Medicine, 3400 Bainbridge Avenue, 5th Floor, Bronx, NY, 10467, USA.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Steinberg
authors.forename: Steven
authors.initials: S
authors.lastname: Williams
authors.forename: David M
authors.initials: DM
authors.lastname: Hoenig
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods*; D019220:High-Energy Shock Waves; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D049451:Nomograms; D056888:Patient Positioning; D010474:Percussion; D011187:Posture; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000628:therapy*