Lithotripsy and the modern imaging department.

Until recently surgery was required to remove unpassed stones from the urinary tract. Today, percutaneous and extracorporeal methods are replacing surgery, such as chemolytic, nephroscopic, ultrasonic, electrohydraulic and extracorporeal shock wave lithotripsy (ESWL). These procedures require close collaboration between the urologist and the radiologist. It is the radiologist who will localize the stone by X-rays or ultrasound and provide the percutaneous approach and dilatation of the tract, leaving the actual stone extraction to the urologist. Even with ESWL supplementary percutaneous procedures are often necessary, again requiring radiologic-urologic teamwork. The percutaneous procedure can be carried out in the imaging department with existing radiologic equipment. Additional X-ray apparatus for the operating room is not necessary. In the Israeli setting of socialized medicine, the involved physicians are unaffected by financial considerations. Collaboration between radiologists and urologists therefore seems assured.