The effect of rate of shock wave delivery on the efficiency of lithotripsy

PURPOSE OF REVIEW: The potential mechanisms of a shock wave rate effect are reviewed here, together with a report on the results of in-vitro, in-vivo and clinical studies that have assessed the effect of altering the shock wave rate on stone breakage and tissue injury by shock wave lithotripsy. RECENT FINDINGS: The vast majority of studies assessing shock wave rate have reported improved stone fragmentation and a reduction in shock wave lithotripsy-induced tissue damage with slower rates of shock wave delivery. However, the optimal shock wave rate has not been determined. SUMMARY: Slower rates of shock wave lithotripsy appear to improve the efficiency of this approach and therefore this suggests the need for a randomized clinical trial to assess shock wave rate.