The procedure usually takes about one hour.
This is done as an outpatient procedure. Which means you can go home after the procedure without being admitted to the hospital unless you are requested by the surgeon.
The surgeon might give you sedatives or local anesthesia to relieve the pain associated with the passage of stone fragments in urine and antibiotics to fight off the possible risk of infection if small crystal damage the urinary tract during its passageway.You will change into a hospital gown and lie on a soft water-filled cushion throughout the procedure. Following the procedure, you will spend about 2 hours in the recovery before being sent home.
You will change into a hospital gown and lie on a soft water-filled cushion throughout the procedure. Following the procedure, you will spend about 2 hours in the recovery before being sent home.
What you should expect following the treatment:
The broken down kidney stone fragments will be passed out in urine in the following days after the procedure. You should expect a mild pain due to the stones passing out through the urinary tract especially when you pass urine. It is advised to drink plenty of water for several weeks following lithotripsy which will help your kidneys flush out these small stone fragments. If there are larger fragments that are unable to be passed out the procedure has to be repeated. It is also advised for you to rest for few days and avoid strenuous work.
What are the advantages of ESWL?
The main advantage of this procedure is that it is on invasive. It simply means that this does not involve surgery. All the complications involved in surgery are avoided during this procedure, the risk of bleeding, damaging the delicate kidney, the risk of surgical site infection and staying for days in the hospital following surgery with catheters to pass our urine and drainage bags coming out of your body and the unpleasant pain can be avoided.
This is an outpatient procedure and after few hours you can go home. You can continue your daily routine following the procedure. The cost is also less compared to surgery.
What are the disadvantages and risks involved?
Unfortunately, no all the kidney stones can be treated with this procedure. Stones larger than 2 cm or stones composed of cysteine ( a type of kidney stone) cannot be broken down by this procedure.
The risks and the discomforts associated with this procedure are:
- Pain associated with the stone fragments passing down your urinary tract: You will be given painkillers.
- Urinary tract infections: You will be provided with prophylaxis antibiotics after the procedure. (The incidence is less than 2%)
- Blockage of the urinary tract by stone fragments: This is rare but if this occurs, the fragments have to be removed by a ureteroscope, a small tube sent up in the urinary tract.
- Bleeding around the outside of the kidney. This can occur due to the shockwaves damaging the soft tissues around your kidney. Based on the scientific literature the post-ESWL peri-renal hemorrhage (bleeding around the kidney) is found to be less than 1%.
You should avoid this:
- If you are pregnant as the shockwaves can damage the baby inside you.
- Have a bleeding disorder.
- Have a urinary tract infection.
- Abnormal kidney anatomy and function.
You can consult your nephrologist or the urologist to get further information on Extracorporeal Shock Wave Lithotripsy (ESWL) for Kidney Stones. This is a very safe and effective treatment for the majority of the kidney stone. You can do this as an outpatient procedure, it is non-invasive and you can get back to your normal daily activities.
References:
Scales, C., Smith, A., Hanley, J., & Saigal, C. (2012). Prevalence of Kidney Stones in the United States. European Urology, 62(1), 160-165. http://dx.doi.org/10.1016/j.eururo.2012.03.052
Rebuck, D., Macejko, A., Bhalani, V., Ramos, P., & Nadler, R. (2011). The Natural History of Renal Stone Fragments Following Ureteroscopy. Urology, 77(3), 564-568. http://dx.doi.org/10.1016/j.urology.2010.06.056
American Urological Association – Medical Management of Kidney Stones. (2017). Auanet.org. Retrieved 23 August 2017, from http://www.auanet.org/guidelines/medical-management-of-kidney-stones-(2014)
Törő, K., & Kardos, M. (2008). Fatal Renal Hemorrhage After Extracorporeal Shock Wave Lithotripsy. Journal Of Forensic Sciences, 53(5), 1191-1193. http://dx.doi.org/10.1111/j.1556-4029.2008.00809.x
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