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Indications For ESWL

Extracorporeal shock wave lithotripsy (ESWL) is a medical procedure used to treat kidney stones. The procedure was developed in 1980 as a noninvasive treatment option that requires minimum anesthesia and recovery time. Having kidney stones can be painful, but it is a treatable medical condition. ESWL involves the use of shock waves to pulverize kidney stones and make them easier to pass through the urinary system.

  1. Kidney Stones

    • Kidney stones are a common urinary disorder caused by the crystallization of various substances in the urine. The stones form in the urine-collecting ducts of the kidneys and travel through the urinary system. The exact cause of the disorder is unknown. Some risk factors include diet, heredity, dehydration and pre-existing medical conditions. Symptoms begin as a sharp pain in the lower back, abdomen and groin. Stones that move through and become lodged in the urinary system cause symptoms of chills, fever, nausea, vomiting, constant urge to urinate, bloody urine and discolored urine. Most stones are small enough to pass and be excreted through the urinary system with minimal pain. However, larger stones require medical treatment to remove them or enable spontaneous passage.

    Indications of ESWL

    • ESWL is frequently used to treat kidney stones. The procedure is not recommended for patients with stones larger than 2 cm, or who are are pregnant, obese, have restricted ureter passages or pre-existing medical conditions that may be negatively affected by shock wave treatment. Physicians prescribe ESWL as a primary treatment option for patients with pre-existing medical conditions where presence of stones may affect kidney function. ESWL is also recommended as a treatment option for professionals who work in situations that may be negatively or dangerously affected by spontaneous complications from the condition.

    Procedure

    • ESWL involves the use of a shock wave generator, focusing system, coupling mechanism, imaging and localization device to perform the procedure. Physicians administer a mild sedative and instruct patients to lie on their backs or abdomens. The imaging devices are used to localize and focus on the stones. A generator is placed on the body and delivers shock waves, at 120 per minute, to break apart the stones. The imaging system tracks the progress of the treatment and location of the stones. The fragmentation breaks the stones into smaller pieces to enable spontaneous passage with minimum pain. A treatment session ranges from 30 to 60 minutes. Duration and number of treatments depends on stone amount and size.

    Complications and Side Effects

    • The procedure is frequently performed with few complications and minimal recovery time. However, some patients may experience an increase in pain, bruising at the site of shock wave application and some internal bleeding. The increase in pain and internal bleeding is due to difficulty passing stone fragments rather than the ESWL treatment itself. These complications are addressed through follow-up medical attention with additional treatments and therapy.

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