5 doctors weighed in:
Is it better to have extracorporeal shock wave lithotripsy (eswl) or percutaneous nephrolithotomy (pcnl)?
5 doctors weighed in

Dr. George Klauber
Pediatrics - Urology
2 doctors agree
In brief: Stone size determine
Shockwave lithotripsy minimally invasive, but not very effective for stones larger than 1 cm in diameter, and can not be used for branching "staghorn" stones.
Can be used for larger stones if infectious in origin because they break up more easier. Percutaneous is more invasive, but usually a "one shot" procedure to clean out all the stone material.Swl requires minimal to no skill, pcnl needs skill.

In brief: Stone size determine
Shockwave lithotripsy minimally invasive, but not very effective for stones larger than 1 cm in diameter, and can not be used for branching "staghorn" stones.
Can be used for larger stones if infectious in origin because they break up more easier. Percutaneous is more invasive, but usually a "one shot" procedure to clean out all the stone material.Swl requires minimal to no skill, pcnl needs skill.
Dr. George Klauber
Dr. George Klauber
Thank
Dr. James Lin
Urology
1 doctor agrees
In brief: Depend...
The size and load of stones, and anatomical structures of kidneys play important roles in choosing eswl or pcnl.
If stone is <1.5 cm, single or 2, go with eswl; if beyond those, go with pcnl. But either way, one has to commit to cope through possible need for intervention with scopic procedure, stenting, laser lithotripsy, etc. That is real life, no magic around.

In brief: Depend...
The size and load of stones, and anatomical structures of kidneys play important roles in choosing eswl or pcnl.
If stone is <1.5 cm, single or 2, go with eswl; if beyond those, go with pcnl. But either way, one has to commit to cope through possible need for intervention with scopic procedure, stenting, laser lithotripsy, etc. That is real life, no magic around.
Dr. James Lin
Dr. James Lin
Thank
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