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Extracorporeal Shock Wave Lithotripsy (ESWL) for
kidney stone
Using EWSL for kidney stone removal
Extracorporeal shockwave lithotripsy (ESWL) is
the most frequently used procedure for kidney
stone removal. This procedure, in effect, can
dissolve a kidney stone.
 ESWL uses highly focused
impulses projected from outside the body to
pulverize kidney stones anywhere in the urinary
system. The stone usually is reduced to
sand-like granules that can be passed in the
patient's urine. Large stones may require
several ESWL treatments. The procedure should
not be used for struvite stones, stones over 1
inch in diameter, or in pregnant women.
There are several types of ESWL devices. In one
device, the patient reclines in a water bath
while the shock waves are transmitted. Other
devices have a soft cushion on which the patient
lies. Most devices use either x rays or
ultrasound to help the surgeon pinpoint the
kidney stone during treatment.
For most types of ESWL procedures, anesthesia is
needed but it may be nonetheless be done on an
outpatient basis. Recovery is quick, and most
people resume normal activities in a few days.
Most patients have blood in their urine for a
few days after kidney stones are removed with
ESWL. There can be bruising and minor discomfort
in the back or abdomen from the shock waves.
Doctors usually tell patients to avoid taking
aspirin and other drugs that affect blood
clotting for several weeks before treatment.
This helps avoid complications.
The shattered kidney stone particles may also
cause discomfort as they pass through the
urinary tract. In some cases, the doctor will
insert a small tube called a stent through the
bladder into the ureter to help the kidney
stone fragments pass more smoothly.
Occasionally, the kidney stone is not completely
shattered after one treatment. Additional
treatments may be needed. ESWL may not be the
best kidney stone removal treatment for very
large stones.
What To Expect After Treatment
ESWL is usually an
outpatient procedure.
You go home after the treatment and do not have
to spend a night in the hospital.
It may take a few days or weeks for all the
stone fragments to pass from your body. You may
have mild pain as the small fragments pass
through the urinary tract.
Why It Is Done
ESWL may be used on people with a kidney stone
that is causing pain or blocking the urine flow.
Stones that are between 4 mm and 2 cm in
diameter are most likely to be treated with
ESWL.
ESWL may work best for kidney stones in the
kidney, not in the ureter. It may be harder for
ESWL to break up a stone that has moved into the
ureter, although this is still possible. Your
surgeon may try to push the stone back into the
kidney with a small instrument (ureteroscope)
and then use ESWL.
ESWL usually is not used if you:
·
Are pregnant. The sound waves and X-rays may be
harmful to the
fetus.
·
Have a bleeding disorder.
·
Have a kidney infection,
urinary tract infection,
or kidney cancer.
·
Have kidneys with abnormal structure or
function.
How Well It Works
After ESWL, stone fragments usually pass in the
urine for a few days and cause mild pain. If you
have a larger stone, you may need more ESWL or
other treatments.
ESWL machines can be low- or high-energy.
Low-energy machines cause less discomfort, but
you may need more treatments before the stone is
broken into pieces small enough to pass.
For 9 out of every 10 patients with kidney
stones smaller than 10 mm-either in the kidney
or in the ureter. ESWL gets rid of all the stone
or leaves only small fragments that don't cause
any symptoms.
ESWL does not replace the need for the
preventive treatment of kidney stones, such as
drinking a lot of fluids.
Risks
Complications of ESWL include:
·
Pain caused by the passage of stone fragments.
·
Blocked urine flow as a result of stone
fragments becoming stuck in the urinary tract.
The fragments may then need to be removed with a
ureteroscope.
·
Urinary tract infection.
·
Bleeding around the outside of the kidney.
What To Think About
ESWL does not successfully treat cystine kidney
stones. These stones do not break up easily.
ESWL is a safe procedure and may be used on
children and on individuals with only one
working kidney. ESWL should not be used if you
have a pacemaker unless a
cardiologist
has determined it is safe.
HOW
DOES LITHOTRIPSY WORK?
The technology behind lithotripsy is very
simple. Using a device called lithotripter, the
urologist localizes and then focuses shockwaves
directly on the stone. The lithotripter is very
precise, delivering the right amount of energy
to break the stone without damaging the organs
or surrounding tissue. Treatment usually
consists of several thousand shocks which break
the stone into very small fragments. These
fragments are passed spontaneously during
urination. The procedure usually lasts about 1
hour and is performed on an outpatient (OPD)
basis. Re-treatment maybe necessary in some
cases to completely disintegrate larger stones.
Usually an overnight hospital stay is not
required and patients may return to normal
activities within as little as 24 hours.
HOW
ARE STONES TREATED?
Until recently, surgery was the most common form
of treatment for kidney stones. Surgery is
painful, leaves a scar, and requires lengthy
recovery period (4-6 weeks). Today, lithotripsy
or ESWL, is the therapy of choice. This
non-invasive technique uses “shock waves”
instead of a knife to remove stones from the
kidney and urinary tract.
-
No scarring
-
Quick recovery time
-
Outpatient procedure
-
Non-invasive
The shockwave passes
harmlessly through the body tissue. When the
shockwave strikes the kidney stone, cracks
appear
on the kidney
stone’s surface. After 1 hour, the stone is
pulverized. The fragments pass out naturally
during urination for a number of days or even
weeks after lithotripsy.
IS LITHOTRIPSY SAFE?
Yes. Lithotripsy is safe, and performed
worldwide with excellent results. The procedure
is non-invasive and is conducted under the
supervision of a highly trained physician and
technician. Occasional side effects are bruising
around the treatment area, blood in urine and
pain for a few days following lithotripsy.
While most people
can undergo lithotripsy, please inform your
doctor if you have high blood pressure, a blood
clotting disorder, or a urinary tract infection.
Pregnant women must not undergo lithotripsy.
Read More on Kidney Stones…
What is a kidney stone?
Kidney stone causes
Kidney stone symptom basics
Other kidney stone symptoms
Kidney stone treatment
options
Surgery as kidney stone treatment
Is there a home remedy for
kidney stones?
Is cranberry juice a natural kidney stone cure?
Causes of kidney stone pain
How painful are kidney
stones?
Removing kidney stones
Using EWSL for kidney stone removal
Other Methods for Kidney
Stone Removal
Kidney stone prevention
What is a good kidney stone
diet?
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