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Improving Urinary Stone Treatment: An Interview with Dr. Lingeman

Improving Urinary Stone Treatment: An Interview with Dr. Lingeman

Title: Better Lithotripsy On the Horizon: Interview with James Lingeman, MD

Author: Delicia Honen Yard

A leading authority on kidney stone disease, James E. Lingeman, MD, of Indiana University Health, updates Renal & Urology News on the state of urinary stone treatment, including a possible rebirth of extracorporeal shock wave lithotripsy and the pursuit of the “holy grail” in flexible ureteroscopy.


ESWL (Extracorporeal shock-wave lithotripsy) has been the standard treatment for urinary tract stones since the 1980s, but it hasn’t seen much improvement since its inception. This is because the basic physics of how the machine works were not fully understood by the companies that built it. Research from James E. Lingeman, MD, a leading authority on kidney stone disease from Indiana University Health, has improved the understanding of the basic science of shock wave physics and how it works. This research has led to the development of a better lithotripter machine that uses low pressures in the focal zone, producing minimal tissue effects on the kidney, making it a better balance between safety and efficacy, according to Dr. Lingeman. The Lithogold, manufactured by TRT, employs a broad focal zone, which makes it easier to hit the stone during treatment. It has a better concept than other machines, according to Dr. Lingeman.

Flexible ureteroscopy is another treatment method that has advanced significantly in the past two decades, which can now treat most stones, and the technology is much less expensive than ESWL. However, for properly selected patients, ESWL is still an attractive option because it is non-invasive. Both ESWL and flexible ureteroscopy have their advantages and disadvantages, but they are both effective in treating urinary tract stones. Dr. Lingeman and fellow researchers at Indiana University School of Medicine are thinking about building their own lithotripter to improve the treatment further. The pursuit of the “holy grail” in flexible ureteroscopy is still ongoing. The developments in these two treatments could help many people who suffer from urinary tract stones.

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