What is shock wave lithotripsy?
Shock Wave Lithotripsy (SWL) is the most common therapy for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment and as a result, the stones are broken into tiny pieces. Other than that, it is also known as Extracorporeal Shock Wave Lithotripsy (ESWL). These are what the words mean:
• Extracorporeal: from outside the body.
• Shock waves: pressure waves.
• Lithotripsy (the Greek roots of this word are “litho” meaning stone, “tripsy” meaning crushed).
So, SWL describes a nonsurgical method for treating stones in the kidney or ureter (the tube going from the kidney towards the bladder) using high-energy shock waves. Stones are broken into “stone dust” or fragments, which are small enough to pass in urine and if large pieces will remain, then an additional therapy is performed.
When can SWL be utilized?
SWL works much better with some stones than others. A Very big stones cannot be treated this way. The size and shape of stone, where it is lodged in your urinary tract, your health, as well as your kidneys’ health will be part with the option to use it. Stones that are smaller than 2 cm in diameter are the very best size for SWL and that the treatment may not also be effective in the very big ones.
Other than that, SWL is also more appropriate for many people than the other people. Simply because x-rays and shock waves are needed in SWL, pregnant ladies with stones are not treated this way. Individuals with bleeding disorders, infections, severe skeletal abnormalities, or those who are morbidly obese are also not generally good candidates for SWL. Moreover, if ever that your kidneys have any other abnormalities, and then your physician might also determine that you need to have a different treatment and if you have a cardiac pacemaker, a cardiologist will decide if you can have SWL or not.
Is it urgent that the patient be treated with a process like this?
If the stone does not pass on its own, then it will certainly require therapy and if you have an infection, severe discomfort, or if your kidney functions are threatened, your doctors will also act quickly. Other than that, if ever that you only have one kidney or have had a kidney transplant, then it is also expected that your stone will be treated much more quickly. If you have large stones or stones in each kidney, your physicians will not wait to treat you.
What does the treatment involve?
You will be positioned on an operating table. A soft, water-filled cushion might be placed on your abdomen or behind your kidney. The body is positioned so that the stone can be targeted precisely with the shock wave. In an older technique, the patient is placed in a tub of lukewarm water. About 1-2 thousand shock waves are required to crush the stones. The total treatment takes about 45 to 60 minutes. Sometimes, physicians insert a tube through the bladder and then thread it up to the kidney just before to SWL. These tubes (called stents) are used when the ureter is blocked. Also, when there’s a risk of infection and in patients with intolerable discomfort or decreased kidney function.
After the process, you will generally stay for about an hour then be allowed to return home if all goes well. You will also be asked to drink lots of liquid, strain your urine though a filter to capture the stone pieces for testing, and you may have to take antibiotics and painkillers. Some researches have reported stones might come out much better if particular drugs (calcium antagonists or alpha-blockers) are used after conducting SWL.
Does the patient need anesthesia?
Yes, although there’s no incision, there is certainly a pain. You and your doctor will talk about whether light sedation and general anesthetics will be used. The choice depends on the technique, the kind of stone and the patient. SWL may be delivered with just mild sedation, but in common, some kind of anesthesia–either local, regional or general–is used to assist the patient remain nonetheless, decrease any discomfort, and this improves the breaking of the stone.
Read here for further reading: https://www.kidney.org/atoz/content/kidneystones_ShockWave.cfm