Intracorporeal lithotripsy

In the past decade, significant advances in endoscopic design and fragmentation technology have provided the urologist with a myriad of options for the treatment of urolithiasis. There is little debate concerning the appropriate selection of ureteroscopic instrument, although which device to use for stone fragmentation is still subject to individual preferences. All methods of intracorporeal lithotripsy have advantages and disadvantages. The issues of the size (USL), safety (EHL), and cost (laser lithotripsy) associated with these modalities continue to be argued. There is no question that lasers are an attractive technology to both physicians and patients, although its significantly greater relative cost should be seriously considered. Ongoing research continues to broaden the spectrum of intracorporeal lithotripsy. Current investigations of laser technology are focusing on such areas as shielded laser lithotripsy, Q-switched YAG, and alexandrite laser lithotripsy. The electro mechanical stone impactor is a variation of the EHL technology, which attempts to overcome the potential for urothelial injury caused by the discharge of the electrohydraulic spark. Other research efforts may soon emerge to provide useful and effective modes of stone fragmentation. Undoubtedly, these technologically driven forces will dramatically influence intracorporeal lithotripsy in the coming years.