Extracorporeal Shockwave Lithotripsy (Eswl): Causes, Symptoms, Treatment and Cost

Extracorporeal Shockwave Lithotripsy (ESWL) is a minimally invasive medical therapy for removing kidney or urinary tract stones. Shock waves are utilised in order to fragment the stones into smaller fragments, which are thus able to move more easily through the urinary system.

The extracorporeal shockwave lithotripsy (ESWL) and the percutaneous nephrolithotomy are the two primary varieties of the ESWL procedure (PCNL).

• Extracorporeal Shockwave Lithotripsy (ESWL): ESWL uses an external source of energy such as sound waves to break down stones into tiny pieces that can be passed out of the body in urine. The procedure can be done in a hospital setting or at home. It is usually done on an outpatient basis with sedation or local anaesthesia.
• Percutaneous Nephrolithotomy (PCNL): PCNL uses a thin tube inserted through a tiny incision in the patient’s back or side to reach and remove large stones from within the kidney or bladder. This type of lithotripsy typically requires hospitalisation with general anaesthesia and may require a longer recovery time than ESWL procedures do.

ESWL is an effective and safe treatment option for many patients suffering from kidney stones, providing numerous benefits over traditional surgical methods.

• Non-Invasive: ESWL is a non-invasive surgery, which means that there is no need for any incisions to be made or for general anaesthesia to be administered. In comparison to conventional surgical procedures, this greatly shortens the recovery period and lowers the chance of developing an infection.
• Painless Procedure: Since no incisions are made and general anaesthesia is not used, ESWL is generally a painless procedure with minimal discomfort during and after the treatment.
• Fast Treatment Time: ESWL treatments typically take less than an hour, as opposed to traditional surgical procedures which can take several hours or even days depending on the complexity of the case.
• Quick Recovery Time: Patients who undergo ESWL treatments typically experience quick recovery times with minimal side effects such as mild soreness or nausea that can be managed easily with medication or rest.
• Cost Effective: The cost of ESWL treatments are generally much lower than those of traditional surgeries due to its shorter treatment time and decreased need for hospitalisation or intensive care units in most cases.

• Extracorporeal Shockwave Lithotripsy (ESWL) is a medical procedure used to treat kidney stones and other solid masses in the urinary tract.
• It can also be used for other conditions where non-surgical removal of solid masses, such as gallstones, is desired.

The risks associated with Extracorporeal Shockwave Lithotripsy (ESWL) are generally considered to be low. Possible risks include:

• Bleeding: There is a possibility of bleeding emanating from the region that was subjected to the shockwaves. Medications or just applying pressure to the region that is hurting can treat this condition well.
• Infection: When doing ESWL, there is a danger of infection, just like there is with any other operation. Antibiotics may be prescribed by your doctor to assist in the prevention of this problem.
• Damage to surrounding organs: The shockwaves used during ESWL can cause damage to nearby organs, such as the kidneys or bladder. Your doctor will monitor for any signs of this complication during and after your procedure.
• Urine retention: Temporary urine retention can occur after ESWL and can be managed with medications or a catheter insertion if needed.
• Pain: Some pain may be experienced in the area where the shockwaves were applied, but this usually subsides within a few days after treatment and can usually be managed with pain medication prescribed by your doctor if necessary.

To prepare for the treatment, it is important that you carefully follow your doctor's instructions regarding any medications and dietary restrictions that may be required.

• It is possible that you will be required to discontinue the use of some drugs, such as aspirin, a few days before the surgery.
• Make arrangements to have someone drive you home after the surgery because you will not be able to drive yourself owing to the anaesthesia or sedative that will have been administered during the treatment.
• During the procedure, you will need to wear comfortable clothes that do not have any metal buttons, zippers, or snaps because these might cause problems with the imaging process.
• Empty your bladder before coming in for your appointment as a full bladder can interfere with imaging during ESWL procedures and increase discomfort during treatment delivery.
• Let your doctor know if you are pregnant or think you might be pregnant since ESWL is not recommended for pregnant women due to potential risks to both mother and baby from radiation exposure during imaging and treatment delivery.

During Extracorporeal Shockwave Lithotripsy (ESWL), high-energy shock waves are focused on the stone, which causes it to fragment into small pieces that can then be passed out of the body in the urine.

The patient will lie down on a specialised table and be positioned in such a way that the shockwaves will be directed towards the stone. An ultrasound or X-ray imaging device is used to guide the treatment and monitor progress.

The entire procedure usually takes about an hour and does not require any incisions or sedation.

• The patient may be asked to sign a consent form indicating that they understand the risks associated with the procedure.
• Patients should make sure that their doctor is aware of any allergies, as well as their medical history, such as previous kidney stones or other medical conditions that could affect the procedure or its outcome.
• The patient should also fast for several hours before the procedure and avoid drinking large amounts of fluids in order to reduce the risk of complications during treatment.
• Certain medications may need to be stopped prior to ESWL, such as anticoagulants or nonsteroidal anti-inflammatory drugs (NSAIDs).
• In some cases, a contrast dye may be used prior to ESWL in order to provide a better image of the stone’s location within the body; this dye can cause allergic reactions in some patients, so it is important they tell their doctor if they have had any problems with dyes in the past.
• Patients should also make sure that they are thoroughly hydrated both before and after ESWL treatments, as this can reduce pain and help speed up recovery time after treatment is complete.

• The patient is positioned on the ESWL machine and an X-ray is taken to precisely locate the stone.
• The patient is secured with straps and a sheet to protect them from radiation exposure.
• Anaesthesia may be given if necessary, depending on the size and location of the stone.
• Once the stone is located, pulses of shockwaves are directed at it through a water-filled cushion or probe placed near or on the skin surface in contact with the body part containing the stone.
• The shockwaves break up larger stones into smaller fragments that can be passed more easily through urine.
• The procedure takes about 45 minutes, after which time X-rays are taken to confirm that all fragments have been broken up and eliminated from the body via urination (or other means).
• After confirming that all fragments have been eliminated, patients are monitored for any complications before being released from care.

• After the procedure, you will be transferred to a recovery area where you will be monitored for at least one hour.
• You will be asked to drink plenty of fluids to help flush out any remaining fragments in the urinary tract.
• In order to lessen the likelihood of getting an infection, your physician can recommend taking antibiotics.
• After about two weeks, your doctor may order an X-ray or ultrasound imaging test to ensure that all fragments have been eliminated from your urinary tract.

The cost of Extracorporeal Shockwave Lithotripsy (ESWL) in India can vary depending on the location and the hospital, but it typically costs between ₹20,000 to ₹0,000.

After ESWL, it is important to maintain a healthy diet to ensure proper healing. Foods that are recommended include:

• Fruits and vegetables: These provide vitamins, minerals, and antioxidants that help with healing and immune system health.
• Whole grains: Whole grains provide fibre, B vitamins, and other nutrients that support digestive health.
• Lean proteins: Eating lean proteins such as beans, fish, poultry, eggs, or tofu can help rebuild muscles damaged during the procedure.
• Products from low-fat dairy cows: Calcium and vitamin D are found in low-fat dairy products, making them beneficial to bone health.
• It is also important to drink plenty of water throughout the day in order to stay hydrated and flush out any remaining stones or debris from the procedure. Avoiding caffeine and alcohol may also be beneficial while recovering from ESWL.

Yes, Extracorporeal Shockwave Lithotripsy (ESWL) is generally considered to be safe. ESWL has been used to treat kidney stones for over 0 years and has a success rate of around 80%. The procedure is minimally invasive, causes minimal pain, and requires no surgical incision.

Most patients report that ESWL is not painful, with some feeling sensations similar to mild discomfort or aching. This is because the shockwaves exert a significant amount of pressure on the body.Some patients may experience pain or cramping during or after treatment and this can be managed with medication if necessary.

The recovery time after Extracorporeal Shockwave Lithotripsy (ESWL) typically takes anywhere between 1-2 days. However, it is important to note that the time it takes to recover will vary from person to person due to individual factors such as the size of their kidney stone and the severity of their condition.

The most common side effects of Extracorporeal Shockwave Lithotripsy (ESWL) include pain or discomfort in the area of treatment, blood in the urine, nausea and vomiting, fatigue, and fever. Other less common side effects may include bruising or swelling at the site of treatment, bleeding around the kidney, an increased risk of urinary tract infection (UTI), problems with kidney function tests, and rarely an allergic reaction to contrast dye.

• Drink Plenty of Fluids: It is essential for patients to drink plenty of fluids after ESWL as this helps to flush out any residual fragments from the treatment site. The recommended amount is 2- litres per day, avoiding alcohol and caffeinated beverages if possible.
• Avoid Heavy Exercise: After undergoing ESWL, it is important that patients avoid strenuous exercise or heavy lifting for at least two weeks following treatment as this can exacerbate swelling or bleeding in the treatment area.
• Monitor Urinary Symptoms: Patients should monitor their urinary symptoms closely after undergoing ESWL and report any changes in frequency, colour, or consistency of urine immediately to their healthcare provider. In addition, they should also report any fever or chills which could be signs of infection due to residual stone fragments left behind from the treatment process.
• Pain Management: Pain is a common side effect following ESWL and can range from mild discomfort to severe cramping depending on the size and number of stones treated during the procedure. Patients should discuss pain relief options with their healthcare provider prior to undergoing treatment as well as afterward in order to manage any pain they may experience post-procedure.
• Follow Up Appointments: It is important for patients who have undergone an ESWL procedure follow up with their healthcare provider within one month afterwards for a post-treatment evaluation and further testing if needed depending on their individual situation.

Extracorporeal Shockwave Lithotripsy (ESWL) is an effective and minimally invasive procedure for treating kidney stones. It can be used to break down stones of all sizes, although larger stones may require more than one treatment session. The success rate of ESWL is high, with most patients being able to pass the stone fragments after treatment.