Extracorporeal Shock Wave Lithotripsy (ESWL) for Kidney Stones

Extracorporeal shock wave lithotripsy, (ESWL) is a type of lithotripsy procedure.  It is also called Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL; Renal calculi-lithotripsy.

What are Kidney stones and Lithotripsy?

Kidney stones (nephrolithiasis) is a common condition in the kidney and in the United States, 10.6% men and 7.1% females are suffering from kidney stones. Kidney stones occur as a result of minerals and other substances in your urine crystallizes in the kidneys forming stones. The size of these stones can vary from small microscopic crystals to large crystals almost as large or even bigger than your kidneys. This image shows actual kidney stones extracted from patients with renal stones. Kidney stones that are smaller than your ureters (the tubes conveying urine from kidney to your bladder) will pass from your kidneys and enter your bladder. They will eventually pass when you urinate. However, this can be really painful if the stone is large.

Lithotripsy is a commonly used procedure in nephrology and nephrolithotomy. This procedure is associated with removal or stones that occur in your kidneys. If the stones are large and cannot pass through your urinary tract it causes obstruction in the urinary tract and you are at risk of infections of the kidney (pyelonephritis), kidney failure and other diseases. These large stones have to be removed by a doctor. The earliest method was nephrolithotomy which meant doing a surgery and removing the stones.  However, this is invasive and all the risks of surgery are associated and kidney is a delicate organ that performs vital functions in your body.

This invasive surgery was the only available option till 1832, when a French Surgeon invented a surgical instrument to crush these stones while inside the bladder allowing the small crushed stone fragments to be passed in the urine, without surgically opening the abdomen. Based on this concept lithotripsy was introduced in the 1980s.

The ureteroscopic method involved a flexible scope to be sent up to the stone and break it using mechanical or light energy. Extracorporeal shock wave lithotripsy, (ESWL) as the name extracorporeal suggest outside of the body, uses sound waves which are high energy shock waves to be focused on to the renal stone from a device. Since then due to its non-invasive nature and fewer complications compared to surgery, this has been the primary treatment option recommended by the American Urological Association guidelines for renal stones 4mm-2cm in size.

Click here to Read more on How ESWL work.