ESWL for Kidney Stone Removal: Everything you should know

Overview
Kidney stones are solid masses of unwanted salts and minerals that can form inside the kidneys. In near about 90 per cent of the cases, the stone is easily passed along with the urine, however, if this does not happen, you may require proper treatment to remove the stone. ESWL or extracorporeal shock wave lithotripsy is one of the available treatment modalities for kidney stone removal, which works by breaking the stones into small parts, thereby making it easier for them to pass through the urinary tract without causing any obstruction.

What is ESWL?
ESWL or extracorporeal shock wave lithotripsy is a non-invasive, advanced treatment option recommended to patients with large kidney stones, that cannot pass via the urinary tract by themselves. The procedure is usually considered for removing stones that are anywhere between 4mm to 2cm in diameter. The procedure not only works for kidney stones that are present in the kidneys but also those which have got stuck in any part of the ureter.

Who can undergo the procedure?
It is important to understand that extracorporeal shock wave lithotripsy is not an option for everyone and your eligibility for the same depends upon various different factors that are to be taken into account. These include the size of the stone, their numbers and composition. It is important to understand that the procedure involves the use of an x-ray technique, and if the patient has any anatomic abnormality, it can make it difficult to carry out the same. It is due to this very reason that your doctor may conduct certain tests and examinations, prior to the procedure, to make sure that you are an eligible candidate.

Also, you may not be considered eligible for the procedure if

• You are pregnant as it involves the use of sound waves and x-rays which can prove to be harmful to the baby.
• You have any sort of bleeding disorder
• You have an infection involving the kidneys of the urinary tract
• You have kidney cancer
• You have structural or functional abnormalities of the kidney

The steps involved in making your kidneys stone-free with ESWL
If you’re planning to undergo the procedure, it is very important to understand what is involved. Being completely non-invasive, the procedure does not call for the need for a long hospital stay. Depending upon the preference of the patient, the procedure may be performed under the influence of either anaesthesia or mild anaesthetics. During the procedure, an X-ray machine will be used for detailed imaging guidance, so as to track the exact location of the stone. The procedure may take about an hour or so.

• You will be required to lie down on a table and the medication will be given intravenously
• Sedatives or mild anaesthetics will be used to make sure that you are comfortable and do not feel any pain during the procedure
• Once you are properly sedated, your medical team will carefully immerse you in a tub filled with water or position you on a water-filled cushion.
• Fluoroscopy or ultrasound technique will be used to track the exact position of the stone, and a sequence of shock waves will be generated to target the same
• If the stone fragments are not able to pass out properly, a stent may be used to open the ureter.
• Once all the stone is fragmented, the procedure will be ended.
• You will be shifted to the recovery room for observation and discharged once the doctors feel that everything is normal.

Life after the procedure
Since extracorporeal shock wave lithotripsy is a completely non-invasive procedure, you do not require weeks or months of rest and can resume your normal day to day activities within a few days.

However, you will surely be required to drink plenty of water, to make sure that stone fragments pass out easily, without causing any pain or discomfort. It was quite natural to notice traces of blood in your urine or slight bruising on the back and abdomen, for the first few days.
In some cases, the patient may be required to take antibiotics, to reduce the risk of infection. You will also need to go for regular follow-ups to make sure that there are no complications.

How successful is the procedure?
Patients who are considered to be a good candidate for extracorporeal shock wave lithotripsy, experience commendable results with 70 to 90 per cent of them getting rid of the stones within the first 3 to 4 months following the procedure. The success rate is higher for patients in which the kidney stone is mobile and present in the upper portion of the urinary tract. It is quite possible that even after the treatment some stone fragments may be left behind. In such cases, the patient will need another session of treatment to get them out.

Conclusion
If you are having kidney stones and think that extracorporeal shock wave lithotripsy might be an option for you, consult with our urology experts, to get yourself evaluated for the same.