Global status of SWL in the era of contemporary urinary stone management—a snapshot analysis amongst 3761 urologists

To study the global practice of SWL, its comparative results with other treatment options, and potential future advances that may boost its clinical relevance. A global cross-sectional survey was conducted amongst members of Société Internationale d’Urologie (SIU). The survey was distributed amongst urologist and urology trainees and captured data on demographics of participants, the use of Shock Wave Lithotripsy (SWL), Ureteroscopy (URS), and Percutaneous Nephrolithotomy (PCNL) in the management of urinary stones. The survey was translated into seven languages. The survey was conducted through the SurveyMonkey platform. We used descriptive statistics where all analyses were conducted using SAS Version 9.4 (Cary, North Carolina, USA). 3,761 urologists across 108 countries replied to the survey. Most participants were from Asia (50.1%), general urologists with over 20 years of clinical practice (61.5%) and coming from High Income countries (84.6%). Most hospitals were equipped with SWL equipment from Dornier (28.1%) or Siemens (17.7%). While 62.7% of the SWL providers received specific SWL training during residency, SWL treatment is usually performed by specialized technicians (48.1%). Higher volume stone centers perform equally SWL and URS while lower volume stone centers balance between SWL, URS and PCNL. Shockwave lithotripsy (SWL) remains widely available but its position in urinary stone management has transformed in favor of ureteroscopy (URS). Advances in robotics, artificial intelligence, and improved training programs may strengthen SWL’s position as a valuable treatment option in the future.