Lithotripsy is a procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (tube that carries urine from kidneys to the bladder. After the procedure, the tiny pieces of stones pass out of your body in your urine The lithotripsy attempts to break up the stone with minimal collateral damage by using an externally applied, focused, high-intensity acoustic pulse. The patient is sedated or anesthetized and needs to lie down in the apparatus' bed. The patient’s back is supported by a water-filled coupling device placed at the level of kidneys. A fluoroscopic x-ray imaging system or an ultrasound imaging system is used to locate the stone and aim the treatment. The patients undergoing this procedure can, in some cases, see for themselves the progress of their treatment with the help of the ultrasound or x-ray monitor. ESWL is the least invasive and the commonest treatment for kidney stones however it provides very low stone free period for the patient. The passage of stone fragments may take a few days or a week and may cause mild pain. ESWL is not without risks. Overall complication rates of ESWL range from 5–20%.
"Extracorporeal" means outside the body and this is the most common type of lithotripsy achieved with short wave radiofrequency. . Patient is taken to the procedure room and will be asked to lie down on an exam table on top of a soft, water-filled cushion. The medicine for pain relief is given so the patient is in relaxed before the procedure begins. The preventive dose of antibiotics is given to minimise any chances of infection during the procedure. Patient receives the general or spinal anaesthesia which makes the entire procedure pain-free. High-energy shock waves, also called sound waves, pass through the body until they hit the kidney stones. If you are awake in the beginning of the procedure, one can feel a tapping feeling . The waves break the stones into tiny pieces. The procedure should take about 45 minutes to 1 hour. A tube placed through the bladder into the kidney. drains urine until all the small pieces of stone are thrown out by the passing urine. The discharge form the hospital in usually on the same day. Not all kidney stones can be removed using lithotripsy. The stone may also be removed by endoscopy method and open surgeries.
ESWL is the least invasive treatment for kidney stones with positive results and majority patient benefit from the same. There are no hospital stays and recovery period is very short. Patient can resume normal activities quecikly.in almost 2 days following the procedure.
Before planning the procedure it is important to inform the doctor of medicines that the patient is consuming including dietary supplements, herbs, non-prescription medicines etc. If the patient is pregnant this must be informed to the doctor. It is contraindicated to undertake this procedure during pregnancy. Blood thinning medicines if being prescribed to you will be stopped before the surgery to reduce the chances of bleeding. Other physiological parameters must be stable before undergoing the procedure. Before procedure the patient has to follow overnight fast and abstain from eating and drinking fluids. Only a sip of water is allowed. After the procedure patient will be under observation in the recovery room for up to about 2 hours. The possible risks include bleeding, trapping of broken stones in the ureter blocking the drainage of the urine and impaired kidney function following the procedure.
What are the instructions for the patients following ESWL?
Patients need to drink as much water as possible and monitor the urine passage for the presence of the fragmented stones.
Are there any risks of this procedure?
This treatment involves high impact waves and the agitation of the urine medium can damage capillaries and there is possibility of bleeding.
Are there medications after the procedure recommended for the patient?
Yes; painkiller and antibiotics are usually prescribed by the doctor.
What are the alternative names to this procedure of removing the kidney stone by breaking?
This procedure is also known as Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL; Renal calculi-lithotripsy. The short name if LITHOTRIPSY.
Why is this procedure performed?
Lithotripsy is used to remove kidney stones that are responsible for cause Bleeding, kidney damage, pain and recurrent Urinary tract infections.
Percutaneous nephrolithotomy (PNL) is the procedure of choice for the treatment of large or complex” renal calculi” commonly known as “renal stones”. This technique is well established, with high rates of success and accepted morbidity. Percutaneous nephrolithotomy technique is in constant evolution. Supine position has been proved as an acceptable option.