Lithotripsy Suite- ESWL, Laser Lithotripsy

ESWL
What is Extracorporeal Shock Wave Lithotripsy (ESWL)?

Extracorporeal Shock Wave Lithotripsy (ESWL) is a procedure to crush down stones in kidneys and ureters into pieces by using shock waves.

Why do I need this procedure?

Your doctor has found that you have one or more stones in your kidney or ureter (tube connecting kidney and bladder) and they need to be removed by using this method.

Are there other methods?

If you don’t have any symptoms and the stone is small, the doctor will wait and watch without any intervention. If the stone is small but you are experiencing uncomfortable symptoms, the telescopic intervention can be done (urethroscopy) to take out the stones or keyhole surgery depending on the decision of the consultant. If there are multiple stones with varying sizes, they can be removed by means of surgery.

What happens during the procedure?

The procedure will be explained by the doctor and the nurse. You will lie on the lithotripsy table and be positioned according to the location of your stone. It can take a while to get you into the ideal position to undergo treatment. Your treatment will be monitored throughout by the nurse. Treatment usually lasts between 30 and 60 minutes depending on the size and location of your stone(s).

Once the treatment starts, you will often feel a sensation of being flicked by an elastic band as well as hearing a ticking noise.

The treatment is started at a low intensity and increased to the level that you can tolerate. It may become more uncomfortable during the procedure and you may feel deeper discomfort at the site of treatment. More painkillers can be given during your treatment if required.

If at any time you feel the treatment is too painful, let the team know so that we can reduce the intensity of the treatment, or stop it altogether.

What are the benefits and risks of this procedure?

ESWL is a day-case procedure, so you can return home on the same day. As it avoids surgery, there is no risk of anesthesia nor complications of surgery.

There are certain risks regarding the procedure;

1. Blood in the urine for a short time as it bruises the kidney slightly
2. Blood clot (Hematoma) around the kidney
3. Pain as a small stone segment passes the ureter (Renal Colic)
4. Need for repeated treatment
5. Failure to break very hard stone and need for other treatment
6. Severe infection with obstruction

Are there other methods?

If you don’t have any symptoms and the stone is small, the doctor will wait and watch without any intervention. If the stone is small but you are experiencing uncomfortable symptoms, the telescopic intervention can be done (urethroscopy) to take out the stones or keyhole surgery depending on the decision of the consultant. If there are multiple stones with varying sizes, they can be removed by means of surgery.

What happens after the procedure?

When the procedure is finished, you will be given painkillers and antibiotics. You will need to rest for a while.

Afterward, the doctor or the nurse will provide you with the necessary instructions to follow at home.

Some painkillers may cause drowsiness and hence it is advisable not to drive after the procedure.

What should I expect when I get home?

You need to drink at least 2-4 Liters of water for the first 48-72 hours to minimize bleeding and to flush small fragments out in the urine. You should take medicines as prescribed by the doctor.

If you experience any intolerable pain, increased amount of blood in the urine, fever or inability to pass urine, you should immediately return to the hospital.

If you have any of the following three conditions, you are not eligible to undergo ESWL.

• Pregnancy
• Blood clotting disorders
• Active urinary infection