Shock Wave Lithotripsy (SWL) is the most common treatment for kidney stones. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. It is sometimes called ESWL: Extracorporeal Shock Wave Lithotripsy.
Kidney stones occur when minerals and other substances in the urine crystallize in the kidneys, forming solid masses, or stones. These may consist of small, sharp-edged crystals or smoother, heavier formation that resemble polished river rocks. They usually exit the body naturally during urination.
However, sometimes the body can’t pass larger formation through urination. This can lead to kidney damage. People with kidney stones may experience bleeding, severe pain, or urinary tract infections. When stones begin to cause these types of problems the doctor may suggest lithotripsy.
The Procedure
Even though there is no incision, there will be pain, so the doctor will administer anesthesia. It will be discussed with the patient whether they will be under light sedation and local anesthesia or general anesthetics.
The patient will be positioned on an operating table. A soft, water-filled cushion may be placed on their abdomen or behind the kidney. The body is positioned so that the stone can be targeted precisely with the shock wave. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes.
Sometimes, doctors insert a tube via the bladder and thread it up to the kidney just prior to SWL. These tubes (called stents) are used when the ureter is blocked, when there is a risk of infection and in patients with intolerable pain or reduced kidney function.
After the procedure, the patient will usually need to stay for about an hour and will then be allowed to return home if all goes well.
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