Break Wave lithotripsy: Clinical outcomes and applications, with Ben H. Chew, MD, MSc, FRCSC

At the 41st Annual Congress of the European Association of Urology in London, England, Ben H. Chew, MD, MSc, FRCSC, an endourologist at the University of British Columbia in Vancouver, British Columbia, Canada, gave a talk titled, “Back to the future: Burst wave lithotripsy.”

Break Wave lithotripsy is a novel, ultrasound-based treatment for urinary tract stones that requires no sedation, anesthesia, bowel preparation, or intravenous access. The device is built on a GE ultrasound platform with a modified generator, developed by the company Sonomotion, and can be deployed in a clinic, emergency department, or hospital setting. Chew explains that patients typically describe the sensation as mild buzzing, and same-day discharge is standard.

Chew notes that the procedural burden of conventional shock wave lithotripsy is considerably higher: Patients require preadmission processing, bowel preparation, sedation, an anesthesiologist, nursing support, and a designated escort home. Break Wave lithotripsy eliminates most of these requirements, which has meaningful implications for departmental workflow and resource allocation. First-in-human studies have demonstrated stone-free rates that are broadly comparable to those of conventional shock wave lithotripsy.

The technology has received FDA 510(k) clearance, with results from the pivotal trial expected to be presented at a forthcoming urology meeting ahead of commercial availability later this year. According to Chew, Break Wave lithotripsy is best suited to renal and ureterovesical junction stones, where ultrasound visualization is most reliable. Midureteric and certain upper-pole stones—particularly when lung tissue obscures the acoustic window — represent current limitations, consistent with the established constraints of diagnostic ultrasound.

Chew said he considers the learning curve modest. Urologists already using ultrasound for percutaneous access will require minimal adaptation, and he sees potential for ultrasound technologists to deliver treatment under urologist supervision, given that stone identification and treatment targeting rely on the same core skill set. Once commercially available, Break Wave lithotripsy is expected to complement existing modalities, offering a less invasive alternative to ureteroscopy and a more accessible option in centers where dedicated lithotripsy equipment or scheduling is limited.