Prediction of shockwave failure in patients with urinary tract stones.

PURPOSE OF REVIEW: To evaluate recent developments in predicting the failure of shockwave lithotripsy when treating patients with urinary tract stones.

RECENT FINDINGS: Although the features of patients with stones, as well as of the stones themselves, associated with refractoriness to shockwave lithotripsy are fairly well defined, refining the preoperative detection of these traits and optimizing the efficacy of shockwave lithotripsy are still under investigation. Several studies have recently focused on improving the radiological appraisal of stone size and composition through the use of axial computed tomography and reconstruction software. Other investigators have researched techniques to increase the efficacy of the technology underlying shockwave lithotripsy, such as varying the shockwave delivery rate and method.

SUMMARY: Investigators have demonstrated different factors and predictors that affect shockwave lithotripsy for stone disease. Continued research will better define patient selection and the role of shockwave lithotripsy in the treatment of urolithiasis.