MINISTRY OF HEALTH TRABZON PROVİNCİAL HEALTH DİRECTORATE SBU KANUNİ TRAİNİNG AND RESEARCH HOSPİTAL

MINISTRY OF HEALTH TRABZON PROVİNCİAL HEALTH DİRECTORATE SBU KANUNİ TRAİNİNG AND RESEARCH HOSPİTAL

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Stone Breakage (ESWL) Unit

Updated: 08/10/2019

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What is ESWL?

ESWL (Extracorporeal shock wave lithotripsy) is the method of breaking stones in kidney and urinary tracts by using shock waves from outside of body (extracorporeally) without operation. Nowadays in suitable patients ESWL can be used as an alternative to stone surgeries such as percutaneous nephrolithotomy and ureteroscopy.

Which stones can be treated with ESWL?

  • Stones that are in kidney and smaller than 2 cm
  • Ureter upper end stones
  • Postoperative residual kidney stones

    How is procedure of stone breaking done?

    After your doctor determines that you have stones suitable for ESWL, an appointment is given for procedure. ESWL is carried out at our lithotripsy unit located on -1st floor of Kaşüstü Campus of our hospital. You should not have urinary tract infection prior to procedure. In case of infection, it is treated by your doctor before procedure. Procedure lasts approximately 30 minutes. Lithotripsy is a one-day procedure. Prior to stone breaking, you are made to wear patient scrub and you are asked to lie down on table of ESWL device. Analgesic medication is administered to prevent feeling pain during lithotripsy procedure. Subsequently, the location of your stone is determined by urology doctor via a portable X-ray device and focusing is done. After that, ultrasound gel is applied to the region of the stone. It is ensured that no air is left between lithotripsy head and your body in order not to decrease the effect of sound waves. Procedure begins with a “click” sound. The focal point of your stone is checked by lithotripsy technician at intervals. Energy level is increased in a controlled way without disturbing. The aim of lithotripsy is to ensure complete fragmentation of the stone. One or more sessions may be required for complete fragmentation of the stone. This is evaluated by your doctor after each session and decision is made according to stone’s condition. In case ESWL fails, other stone surgery methods can be used.

    Conditions not suitable for ESWL application:

  • Pregnancy
  • Patients with bleeding disorder
  • Presence of obstructionin urinary system at a point below stone
  • Patients with cardiac pacemaker
  • Patients with aneurysm close to kidney

    Complications that may occur after ESWL:

  • Broken stone fragments can fall into and obstruct urinary tract. Therefore, an endoscopic surgery may be needed(10-20%).
  • Pain
  • Skin redness
  • Urinary tract infection
  • Bleeding in urine and as a possible result of this, inability to urinate
  • Rarely, bleeding around kidney

    Precautions and suggestions after ESWL:

  • At least 2 liters of water should be drunk daily after ESWL.  
  • You should make physical activities like walking after ESWL. Because movement helps you pass stone fragments.
  • You can monitor the fallen stone fragments by urinating into a container.
  • In case of fever or severe pain, you should apply to a hospital.
  • You should comply with appointments and prescribed drug treatments.