Extracorporeal Shock Wave Lithotripsy (ESWL)

When do you need an ESWL?

• Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure used to treat kidney stones and other urinary tract stones. It is typically recommended in the following situations:

• Small to Medium-Sized Kidney Stones: ESWL is most effective for kidney stones that are less than 2 centimetres (about 0.8 inches) in diameter. Stones larger than this may require alternative treatments such as percutaneous nephrolithotomy (PCNL) or ureteroscopy.

• Location of the Stone: ESWL is most commonly used to treat kidney stones located in the kidney or upper ureter. Stones in the lower part of the ureter or those located close to the bladder may be better treated with other procedures.

• Stone Composition: ESWL is effective for treating certain types of kidney stones, including calcium-based stones and some types of uric acid stones. However, it may be less effective for cystine stones or certain other types of stones.

• Patient Preference or Health Considerations: ESWL is a non-invasive procedure that does not require incisions, so it may be preferred by patients who want to avoid surgery or have medical conditions that make surgery risky.

• Pregnancy: ESWL may be considered as a treatment option for kidney stones in pregnant women, as it does not expose the fetus to radiation or require anaesthesia. However, it is typically avoided during the first trimester of pregnancy.

Causes and Risk Factors

• Dehydration: Insufficient fluid intake leads to concentrated urine.

• Dietary Factors: High intake of oxalate-rich foods like beets, chocolate, and nuts.

• Genetic Predisposition: A family history of kidney stones may increase the risk.

• Medical Conditions: Certain conditions, like urinary tract infections, can contribute.

• Age: Individuals between 30 and 60 years are more susceptible.

• Gender: Men are generally more prone to kidney stones.

• Obesity: Higher body mass index (BMI) can increase the risk.

• Geographical Location: Certain regions may have higher rates due to climate and diet.

Treatment Details

Surgical Approaches:

• Extracorporeal Shock Wave Lithotripsy (ESWL): Non-invasive shock waves to break down stones.

• Ureteroscopy: A thin tube is inserted through the urethra to remove or break stones.

• Percutaneous Nephrolithotomy (PCNL): Surgical removal through a small incision in the back.

Anesthesia:

• Local or General Anesthesia: Depending on the complexity and type of surgery.

• Sedation: Administered to keep the patient relaxed and comfortable during the procedure.

Recovery

Postoperative Care

• Monitoring: Observation for complications such as bleeding or infection.

• Pain Management: Medications to control postoperative pain.

• Hydration: Encouraging increased fluid intake to flush out any remaining stone fragments.

Return to Normal Activities:

• Varies by Procedure: ESWL allows a quick return to normal activities, while PCNL may require more downtime.

• Follow-up Appointments: Scheduled to monitor recovery progress.