title: [New strategies and protocols in SWL.]
abstract: OBJECTIVE
  An update of the new treatment strategies in extracorporeal lithotripsy as a valid therapeutic alternative in the management of urinary calculi.
  
  
  METHODS
  We performed a search and review of the most recent literature which responded to the terms "best practices", "update", "optimization", "practice pattern" in lithotripsy. Only articles written in English or Spanish were selected.
  
  
  RESULTS
  The use of a stepwise voltage ramping during extracorporeal lithotripsy with or without pause before the first rise of energy, a decreased delivery rates and the use of a higher number of shock waves per session are shown as alternatives to improve the effectiveness with optimum safety profile.
  
  
  CONCLUSIONS
  Extracorporeal lithotripsy is still an effective and minimally invasive treatment, and it has an important role in the treatment of urolithiasis. New treatment strategies are being developed to increase the effectiveness with a similar safety profile.
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Budía Alba
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Bahilo Mateu
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: Guzmán
authors.initials: G
authors.lastname: Ordaz Jurado
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: José Daniel
authors.initials: JD
authors.lastname: López-Acón
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: Marta
authors.initials: M
authors.lastname: Trassierra Villa
authors.affiliation: Unidad de Litotricia y Endourología. Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Boronat Tormo
mesh_terms: D002985:Clinical Protocols; D006801:Humans; D008096:Lithotripsy / Q000379:methods* / Q000592:standards; D055585:Physical Phenomena; D016896:Treatment Outcome; D052878:Urolithiasis / Q000628:therapy*