Shock Wave Lithotripsy
Extracorporeal (outside of the body) Shock Wave Lithotripsy (stone crushing) or ESWL uses shockwaves to break the kidney stone into smaller pieces so they can more easily travel through the urinary tract and pass from the body
- The surgery is usually an outpatient procedure performed under general anesthesia and lasts between 45 and 60 minutes.
- After you are placed under general anesthesia, the surgeon uses x-rays to precisely locate the stone. High-energy sound waves travel through skin and other internal organs and disintegrate the kidney stone into fine sand-like particles that can be passed through the urinary tract.
- In some cases a stent (a plastic tube) may be used to bypass a stone, relieve obstruction or to keep the ureter from swelling shut after the procedure. This is done more commonly for stones greater than 1cm in size.
After the procedure stone fragments usually pass in the urine for a few days and can cause mild pain. Approximately 85% of patients are stone free following the initial procedure. Complications with ESWL occur rarely. You may be advised to undergo inversion therapy after the procedure to help maximize the clearance of stone fragments.
Possible Complications include:
• About 15% of patients have residual fragments of stones which may require additional treatment.
• Discomfort caused by the passage of stone fragments.
• Blocked urine flow as a result of stone fragments becoming stuck in the urinary tract requiring an emergency procedure to relieve the blockage.
• Urinary Tract Infection.
• Bleeding around the kidneys.
Please observe the following Pre-Operative Guidelines:
• You should stop the following medications one week prior to surgery: aspirin (ASA), NSAIDs (Motrin, Advil, ibuprofen), Coumadin, Lovenox, Celebrex, and Plavix. Please contact us if you are unsure about which medications to stop, and do not stop any medication without contacting your prescribing physician
• It is very important that your last urine culture show no bacteria before the procedure.
• The day before your surgery start the pre-operative bowel prep: 2 bottles of Magnesium Citrate (AM, PM), 2 fleet enemas (AM, PM). Both medications are available over-the-counter at your pharmacy.
• Have nothing by mouth after midnight the night prior to your procedure unless otherwise instructed by the anesthesiologist.
After the procedure:
• Although the procedure is minimally invasive it may be physically taxing, you should allow for a day or two of restful recovery time.
• Most patients experience some degree of discomfort/pain for a day or two after the ESWL procedure. The pain will lessen over the following days. It is normal to see blood in the urine for up to several weeks after the procedure.
• Please contact us if you pain continues to increase, you observe large amounts of blood or blood clots in your urine, nausea, vomiting or diarrhea, notice swelling in your calf or thigh, or if you have a fever above 101°F. All these may be indicators of an injury or serious infection.
• It is also necessary to schedule follow-up visits between one and two weeks after the procedure to assess progress.