The use of extracorporeal shock wave lithotripsy in aviators.

Nephrolithiasis presents a common management problem for the flight surgeon, whose patients must be excluded from flying duties for weeks or months during diagnosis and treatment. Extracorporeal shock wave lithotripsy (ESWL) has recently become available for clinical use and represents a totally noninvasive method of managing urinary tract calculi. The extremely low risk and rapid recovery time associated with ESWL make it preferable not only to conservative medical management and conventional surgical treatment but also to the newer invasive procedures, such as percutaneous nephrolithotomy. A case is described in which a military pilot is eligible for return to flying status within 3 weeks of initial consultation following treatment of symptomatic nephrolithiasis with ESWL. The contraindications and potential complications of ESWL are also discussed.