Different international associations have proposed their own guidelines on urolithiasis. However, the focus is primarily on an overview of the principles of urolithiasis management rather than step-by-step technical details for the procedure. The International Alliance of Urolithiasis (IAU) is releasing a series of guidelines on the management of urolithiasis. The current guideline on shockwave lithotripsy (SWL) is the third in the IAU guidelines series and provides a clinical framework for urologists and technicians performing SWL. A total of 49 recommendations are summarized and graded, covering the following aspects: indications and contraindications; preoperative patient evaluation; preoperative medication; prestenting; intraoperative analgesia or anesthesia; intraoperative position; stone localization and monitoring; machine and energy settings; intraoperative lithotripsy strategies; auxiliary therapy following SWL; evaluation of stone clearance; complications; and quality of life. The recommendations, tips, and tricks regarding SWL procedures summarized here provide important and necessary guidance for urologists along with technicians performing SWL. PATIENT SUMMARY: For kidney and urinary stones of less than 20 mm in size, shockwave lithotripsy (SWL) is an approach in which the stone is treated with shockwaves applied to the skin, without the need for surgery. Our recommendations on technical aspects of the procedure provide guidance for urologists and technicians performing SWL.

Centre National Hospitalier et Universitaire Cotonou Benin

Department of Pharmacology University of Michigan School of Medicine Ann Arbor MI USA

Department of Urology 1st Affiliated Hospital of Guangzhou Medical University Guangdong Key Laboratory of Urology Guangzhou China

Department of Urology 1st Affiliated Hospital of University of South China Henyang China

Department of Urology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Urology Biruni University Medical School Istanbul Turkey

Department of Urology Cambridge University Hospitals Cambridge UK

Department of Urology Faculty of Medicine Tanta University Tanta Egypt

Department of Urology Florence Nightingale Hospitals Group Istanbul Turkey

Department of Urology Hamad Medical Corporation Doha Qatar

Department of Urology Hospital de Clinicas Jose de San Martin Buenos Aires Argentina

Department of Urology Hospital of the Sisters of Charity Vienna Austria

Department of Urology Huazhong University of Science and Technology Union Shenzhen Hospital Shenzhen China

Department of Urology Jiangning Hospital Nanjing Medical University Nanjing China

Department of Urology La Fe Polytechnic University Hospital Valencia Spain

Department of Urology Nuffield Department of Surgical Sciences University of Oxford Oxford UK

Department of Urology San Bassiano Hospital Vicenza Italy

Department of Urology Specialty Hospital La Raza National Medical Center of the Mexican Institute of Social Security Mexico City Mexico

Department of Urology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China

Department of Urology UZ Gent Ghent Belgium

Division of Urologic Surgery Duke University Medical Center Durham NC USA

Division of Urology Department of Clinical Science Intervention and Technology Karolinska Institutet Stockholm Sweden

The 2nd Affiliated Hospital of Zhengzhou University Zhengzhou China

University of Munich Munich Germany; University of Regensburg Regensburg Germany

Urology Department Meram School of Medicine Necmettin Erbakan University Konya Turkey

Urology Division Istituto Neurotraumatologico Italiano Grottaferrata Rome Italy

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