Course Content
Disclaimer
This course is designed for educational purposes only. It focuses on the concepts and clinical understanding of shockwave lithotripsy. All energy settings, system limits, and device-specific protocols must be followed as per the manufacturer’s recommendations. Lithotripsy Academy does not replace hands-on training or clinical judgment. Users are responsible for applying their own expertise and adhering to local guidelines and safety standards.
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Disclaimer
01:11
Introduction
Understand why diabetic patients require a modified approach to shockwave lithotripsy and how this course helps you perform ESWL safely and effectively.
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Introduction
00:58
Evidence overview
Explore the scientific evidence behind ESWL in diabetic patients, including stone composition, infection risk, and long-term safety considerations.
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Evidence overview
02:42
Biology of stone in Diabetes
Understand how diabetes alters stone composition, promotes uric acid stone formation, and impacts ESWL targeting and treatment strategy.
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Biology of stone in Diabetes
01:18
Pre-Treatment Protocol
Learn how to prepare diabetic patients for ESWL with proper infection screening, metabolic control, and imaging-based planning to ensure safe treatment.
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Pre-Treatment Protocol
02:19
Intra-Treatment Protocol
Master the technical execution of ESWL in diabetic patients using controlled ramping, precise targeting, and optimized shockwave delivery.
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Intra-Treatment Protocol
01:41
Complications
Understand the key complications of ESWL in diabetic patients, with focus on infection, renal hematoma, and their clinical relevance.
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Complications
01:19
Post-Treatment Protocol
Learn how to safely monitor diabetic patients after ESWL with focus on infection detection, metabolic stability, and early complication management.
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Post-Treatment Protocol
00:31
Contraindications
Identify when ESWL should be avoided or modified in diabetic patients to ensure safety and optimal clinical outcomes.
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Contraindications
00:26
Take home message
Key principles to safely perform ESWL in diabetic patients with a structured, controlled, and evidence-based approach.
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Take home message
00:16
Quiz
Test your knowledge
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Diabetes
00:15:00
SWL in the Diabetic Patient
About Lesson

Diabetes mellitus is increasingly encountered in patients undergoing shockwave lithotripsy (ESWL) for kidney stones. However, managing these patients requires more than routine treatment protocols. Diabetes influences stone composition, increases susceptibility to infection, and alters renal tissue response to shockwaves—making procedural planning and execution more complex.

In clinical practice, many operators underestimate the impact of diabetes on treatment outcomes. Uric acid stones are more common, often radiolucent, and may present targeting challenges during fluoroscopy-guided SWL. At the same time, impaired immune function and microvascular changes increase the risk of infection and renal injury if treatment is not carefully controlled.

This course introduces a structured and practical approach to performing ESWL in diabetic patients. It focuses on key decision points—patient selection, infection screening, imaging strategy, and technical execution—while integrating evidence-based insights with real-world operator experience.

By understanding these foundational concepts, you will be better prepared to adapt your technique, improve safety, and deliver consistent clinical outcomes in this high-risk patient group.

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