title: Extracorporeal Shock Wave Therapy: Current Perspectives and Future Directions.
abstract: OBJECTIVE
  Since its introduction, extracorporeal shock wave lithotripsy (ESWL) has undergone a variety of changes; however, it remains one of the most utilized treatment modalities for urolithiasis. The goal of this review is to provide the practicing urologist an update on contemporary trends, new technologies, and related controversies in utilizing ESWL for stone treatment.
  
  
  RESULTS
  ESWL use has come under scrutiny with a shift in focus to cost-effectiveness and healthcare outcomes. Fortunately, advances in lithotripter technology have spawned several generations of devices that strive to improve stone-free rates and decrease complications. Most of all, a focus on patient selection criteria has helped improve procedural success. Years of experience utilizing ESWL for stone treatment have helped urologists better optimize its use and minimize complications. Improvements in technique along with more stringent patient and stone selection have helped ESWL remain a mainstay in the treatment of stone disease.
authors.affiliation: Philadelphia College of Osteopathic Medicine, Philadelphia, PA, 19131, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Lawler
authors.affiliation: Department of Urology, Einstein Healthcare Network, Philadelphia, PA, 19141, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Ghiraldi
authors.affiliation: Department of Urology, Einstein Healthcare Network, Philadelphia, PA, 19141, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Tong
authors.affiliation: Department of Urology, Einstein Healthcare Network, Philadelphia, PA, 19141, USA. justinfriedlander@gmail.com.|Division of Urologic Oncology and Urology, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA. justinfriedlander@gmail.com.|Einstein Healthcare Network, Temple Health and the Fox Chase Cancer Center, 1200 Tabor Road Moss / 3 Sley, Philadelphia, PA, 19141, USA. justinfriedlander@gmail.com.
authors.forename: Justin I
authors.initials: JI
authors.lastname: Friedlander
mesh_terms: D006801:Humans; D007669:Kidney Calculi / Q000628:therapy; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods; D018579:Patient Selection; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000628:therapy; D052878:Urolithiasis / Q000628:therapy
keywords: ESWL; Lithotripter; Percutaneous nephrolithotomy; Ureteroscopy; Urinary tract stones; Urolithiasis