The Use of Radial Extracorporeal Shockwave Therapy in the Treatment of Urethral Urolithiasis in the Horse: A Preliminary Study

Background: Radial extracorporeal shockwave therapy (ESWT) is widely used in equine practice for the treatment of orthopedic problems. However, its original use as a lithotripsy device in human and canine urology led us to postulate that it could be used as an alternative to the surgical treatment of urethral calculi in horses. Hypothesis: Radial ESWT can easily and safely fragment calculi in the distal urethra of the horse. Animals: Two postmortem cases and 1 live case of obstructive urinary disease admitted at the Veterinary Teaching Hospital of Liege. Methods: A radial shockwave device was directly applied to the urethra in an attempt to fragment calculi. An ex vivo trial was performed on the same retrieved calculi to investigate pressure settings in order to obtain complete fragmentation of the calculus. Results: In all cases, radial ESWT was able to fragment the calculus partially, enabling retrieval of the remaining fragments via the urethra. Much higher pressure settings than those used for in vivo partial fragmentation were necessary to obtain complete destruction of the calculi ex vivo. Conclusions and Clinical Importance: This brief report suggests the use of radial ESWT as a safe and useful alternative to more invasive surgical management of urethral calculi in horses.