Introduction and Purpose: Extracorporeal shockwaves lithotripsy (SWL) is the treatment of choice for small non-complicated upper urinary tract calculi because of its non-invasive nature. This review is intended to provide practical guidance for urologists to optimize the use of SWL in clinical practice in order to achieve the maximum stone-free rate and minimize the incidence and severity of complications..
Methods: A PubMed search using the keywords SWL, extracorporeal shockwaves, and ESWL was conducted for articles published in the past 20 years. In addition, recent international guidelines of urolithiasis were reviewed.
Results: All relevant research articles, reviews and metanalyses were read to construct a clinically oriented guidance for indications, contraindications, pre-SWL preparation, patients' management during and after SWL session, and methods to improve efficiency.
Conclusions: The keys to achieve best stone-free rates with minimal complications after SWL are proper patients' selection, adherence to guidelines recommendations to improve stone disintegration, and adequate follow-up till