Authors' recommendations: ESWL is currently the most common treatment for renal stones due to its noninvasive nature. Based on the limited evidence from a few RCTs and controlled clinical trials, SWL appears to have lower stone-free rates, higher stone recurrence and re-treatment rates in patients with kidney stones, when compared to other minimally invasive surgical modalities. No serious adverse events related to SWL were reported, but patients treated with SWL tended to have more residual stone fragment. A definite conclusion about the clinical effectiveness of SWL cannot be made because of lacking compelling evidence. Two guidelines provide guidance on the treatment of gallstones. Lithotripsy is not recommended as a primary treatment for simple gallstone disease, while ESWL can be considered for patients with difficult common bile duct stones who are not candidates for open surgery. No economic evaluations were identified to assess the cost-effectiveness of different treatment modalities for renal stones or gallstones. In the future, well-designed clinical trials could help to provide more rigorous evidence on the effectiveness of lithotripsy. Economic evaluations, especially within a Canadian context, are needed to evaluate the cost-effectiveness of lithotripsy treatment compared to other minimally invasive surgical interventions.

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf/L0133_Lithotripsy_final.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)