**11. The future of ESWL in the year 2038**

Understanding all effects of ESWL will lead to reliable production of <2 mm as sized reduc‐ tion of the stones instead of fragmentation. This will result in a sawing back to non‐touch shock wave lithotripter due to better shock wave generators with larger focal zones, respira‐ tory regulated hit control based on color duplex ultrasound and computer‐assisted shock wave navigation adapted to the individual anatomy. All will lead to increasing the quality of stone disintegration with almost complete pulverization of the stone, and these techniques can be applying without anesthesia producing no side effects [47].
